酚妥拉明联合速尿治疗肺炎伴心功能不全患儿的疗效观察

The observation on effect of phentolamine combined with furosemide to treat pediatric pneumonia with cardiac insufficiency

目的分析探讨酚妥拉明联合速尿治疗小儿肺炎合并心功能不全的临床疗效。方法选取我院于2016年5月至2018年5月期间收治的94例小儿肺炎合并心功能不全患儿,按照随机数字表法将所有患儿随机分为对照组和试验组两组,两组患儿均给予常规治疗干预,试验组患儿在此基础上联合使用酚妥拉明和呋塞米进行治疗;观察比较两组患儿的症状体征消失时间和临床疗效,对比两组患儿的心电图改善情况和心脏功能改善情况。结果试验组患儿的总有效率为93.62%,显著高于对照组患儿的72.34%(χ^2=9.274,P<0.05)。试验组患儿的住院时间和心力衰竭控制时间、喘息消失时间以及肺部啰音消失时间分别为(7.37±2.37)d、(1.29±0.62)d、(2.83±1.02)d、(3.48±1.12)d,均显著低于对照组的(11.09±3.29)d、(2.63±0.78)d、(6.64±1.92)d、(8.36±2.34)d(t=-6.290、-9.220、-12.014、-12.896,均P<0.05)。两组患儿治疗前后的心功能情况并无明显差异(t=-0.943、0.508,均P>0.05);经过治疗后试验组患儿的左室舒张末容积为(77.29±7.83)mL,显著高于对照组患儿的(62.39±6.48)mL(t=10.050,P<0.05);经过治疗后试验组患儿的左室收缩末容积为(43.20±5.21)mL,显著低于对照组患儿的(54.38±7.55)mL(t=-8.356,P<0.05)。经过治疗后试验组患儿的QTc间期和QRS波时限、PR间期、短阵室性心动过速数以及室性早搏数等指标均明显优于对照组患儿(t=-6.023、-6.233、-6.207、-12.368、-4.597,均P<0.05)。结论对于小儿肺炎合并有心功能不全的患儿采用酚妥拉明联合速尿治疗能够大大减少心电图异常情况的出现,有效改善了患儿的心脏结构和功能,安全性高,疗效显著,值得在临床上进一步推广运用。

Objective To analyze the clinical effect of phentolamine combined with furosemide to treat pediatric pneumonia with cardiac insufficiency.Methods 94 children with infantile pneumonia with cardiac insufficiency were selected from May 2016 to May 2018 in our hospital,and divided into two groups according to random number table method.Test group and control group were all given conventional treatment,and children in test group were on the basis of the combination of phentolamine and Sammy for therapy.Compared with the observation of symptom and physical signs disappearance time and clinical efficacy of the two group children,the improvement of ECG and cardiac function of the two group children were compared.Results The total effective rate of the test group was 93.62%,which was significantly higher than that of the control group 72.34%(χ^2=9.274,P<0.05).The hospitalization time,heart failure control time,wheezing time and lung rale disappearance time in the test group were(7.37±2.37) d,(1.29±0.62) d,(2.83±1.02) d,(3.48±1.12) d,which were significantly lower than those in the control group(11.09±3.29) d,(2.63±0.78) d,(6.64±1.92) d,(8.36±2.34) d(t=-6.290,-9.220,-12.014,-12.896,all P<0.05).There was no significant difference in cardiac function between the two groups before and after treatment(t=-0.943,0.508,all P> 0.05);After treatment,the left ventricular end-diastolic volume of the patients in the test group was(77.29±7.83)mL,which was significantly higher than that in the control group(62.39±6.48)mL(t=10.050,P<0.05).After treatment,the left ventricular end-systolic volume in the test group was(43.20±5.21)mL,which was significantly lower than that in the control group(54.38±7.55)mL(t=-8.356,P<0.05).QTc interval and QRS wave time in the test group after treatment,the parameters of limited PR interval,short ventricular tachycardia and ventricular premature beats were significantly better than those of control group(t=-6.023,-6.233,-6.207,-12.368,-4.597,all P< 0.05).Conclusion For children with pneumonia complicated with cardiac insufficiency,the treatment of phentolamine combined with furosemide can greatly reduce the appearance of abnormal electrocardiogram,effectively improve the cardiac structure and function of children,which have high safety and remarkable curative effect.It is worth for further popularizing in clinic.