多巴胺联合酚妥拉明辅助治疗小儿重症肺炎合并心力衰竭的效果观察

Effects observation of dopamine combined with phentolamine in adjuvant treatment of severe pneumonia in children with heart failure

目的观察多巴胺联合酚妥拉明辅助治疗小儿重症肺炎合并心力衰竭的临床效果。方法选取2017年12月-2019年12月泉州市妇幼保健院·儿童医院儿科收治的重症肺炎合并心力衰竭患儿60例,使用抽签法随机分为观察组和对照组各30例。对照组给予常规治疗,观察组在对照组的基础上给予多巴胺联合酚妥拉明治疗。比较2组临床疗效、阳性体征消失时间、啰音消失时间、心力衰竭纠正时间、住院时间、治疗前后炎性因子水平及血气分析指标。结果观察组总有效率为96.67%,高于对照组的80.00%(χ2=4.043,P <0.05);观察组阳性体征消失时间、啰音消失时间、心力衰竭纠正时间及住院总时间均短于对照组(P <0.01);治疗后,2组TNF-α、CRP及IL-8水平均低于治疗前,且观察组低于对照组(P <0.01);治疗后,2组PaO2及PaO2/FiO2均高于治疗前,Pa CO2均低于治疗前,且观察组变化幅度大于对照组(P <0.01)。结论多巴胺联合酚妥拉明辅助治疗小儿重症肺炎合并心力衰竭可改善患儿临床症状,提升治疗效果,加快其康复。

Objective To observe the clinical effect of dopamine combined with phentolamine in adjuvant treatment of severe pneumonia in children with heart failure.Methods From December 2017 to December 2019,60 children with severe pneumonia and heart failure admitted to Department of Pediatrics,Quanzhou Women’ s and Children’ s Hospital were selected.Using lottery,they were randomly divided into observation group and control group,each of 30 cases.The control group was given conventional treatment,and the observation group was given dopamine combined with phentolamine on the basis of the control group.The clinical efficacy,disappearance time of positive signs,disappearance time of rales,correction time of heart failure,hospitalization time,inflammatory factor levels and blood gas analysis indexes before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 96.67%,which was higher than 80.00% of the control group(χ2= 4.043,P < 0.05);The disappearance time of positive signs,the disappearance time of rales,the correction time of heart failure and the total length of hospitalization in the observation group were shorter than those in the control group(P < 0.01);After treatment,the levels of TNF-α,CRP and IL-8 in the two groups were lower than before treatment,and the observation group was lower than control group(P < 0.01);After treatment,the PaO2 and PaO2/FiO2 in the two groups were higher than before treatment,Pa CO2 was lower than before treatment,and the observation group changed more than control group(P < 0.01).Conclusion Dopamine combined with phentolamine in adjuvant treatment of severe pneumonia in children with heart failure can improve the clinical symptoms of children,enhance the treatment effect,and speed up their recovery.