小剂量多巴胺联合多巴酚丁胺治疗小儿重症腺病毒肺炎的临床研究

Clinical study of low-dose dopamine combined with dobutamine hydrochloride in the treatment of severe adenovirus pneumonia in children

目的探讨小剂量多巴胺联合多巴酚丁胺治疗小儿重症腺病毒肺炎的临床效果。方法58例重症腺病毒肺炎患儿,按照随机数字表法分为研究组和对照组,每组29例。对照组予以常规治疗,研究组在常规治疗基础上加用小剂量多巴胺联合多巴酚丁胺治疗。对比两组患儿氧疗时间、发热消失时间、儿童重症监护病房(PICU)住院天数、肺部湿啰音消失时间及治疗后血气分析指标[动脉血二氧化碳分压(PaCO2)、氧分压(PaO2)、B型脑钠肽(BNP)]。结果研究组患儿的发热消失时间、肺部湿啰音消失时间、氧疗时间、PICU住院天数分别为(2.89±0.76)、(2.26±0.27)、(2.03±0.25)、(1.37±0.23)d,均显著短于对照组的(5.07±1.69)、(4.68±0.79)、(4.12±0.68)、(3.48±0.84)d,差异具有统计学意义(P<0.05)。研究组治疗后的动脉血PaCO2(6.65±1.71)kPa、BNP(85.42±7.41)pg/ml均低于对照组的(7.68±1.27)kPa、(113.45±12.35)pg/ml,PaO2(7.65±1.56)kPa高于对照组的(6.66±1.43)kPa,差异具有统计学意义(P<0.05)。结论小剂量多巴胺联合多巴酚丁胺可有效改善小儿重症腺病毒肺炎的血气分析指标,促进临床症状改善,临床疗效确切,可推广。

Objective To discuss the clinical effect of low-dose dopamine combined with dobutamine hydrochloride in the treatment of severe adenovirus pneumonia in children.Methods A total of 58 children with severe adenovirus pneumonia were divided into research group and control group by random numerical table,with 29 cases in each group.The control group received conventional therapy,and the research group received low-dose dopamine combined with dobutamine hydrochloride on the basis of conventional therapy.The oxygen therapy time,fever disappearance time,hospitalization time of pediatric intensive care unit(PICU)and disappearance time of lung wet rales and blood gas analysis indexes[arterial partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),B-type natriuretic peptide(BNP)]after treatment were comapred between the two groups.Results The fever disappearance time,disappearance time of lung wet rales,oxygen therapy time and hospitalization time of PICU of the research group were(2.89±0.76),(2.26±0.27),(2.03±0.25)and(1.37±0.23)d,which were significantly shorter than those of the control group(5.07±1.69),(4.68±0.79),(4.12±0.68)and(3.48±0.84)d,and the difference was statistically significant(P<0.05).After treatment,PaCO2(6.65±1.71)kPa and BNP(85.42±7.41)pg/ml of the research group were lower than those of the control group(7.68±1.27)kPa,(113.45±12.35)pg/ml,and PaO2(7.65±1.56)kPa of the research group was higher than that of the control group(6.66±1.43)kPa,and the difference was statistically significant(P<0.05).Conclusion Low-dose dopamine combined with dobutamine hydrochloride can effectively improve the blood gas analysis indexes of children with severe adenovirus pneumonia,promote the improvement of clinical symptoms,and the clinical efficacy is definite.It can be promoted.