小剂量多巴胺与多巴酚丁胺联合治疗小儿重症肺炎的效果

Effect of Low-Dose Dopamine Combined with Dobutamine on Children with Severe Pneumonia

目的探讨小剂量多巴胺与多巴酚丁胺联合治疗小儿重症肺炎的效果。方法回顾性选取许昌市人民医院2018年4月至2019年10月收治的85例重症肺炎患儿,根据药物治疗方案分为联合药物治疗组(n=43)与单药治疗组(n=42)。两组均接受常规的对症支持治疗,单药治疗组接受多巴酚丁胺治疗,联合药物治疗组在单药治疗组基础上接受小剂量的多巴胺进行联合治疗。对比两组疗效、临床主要症状(肺啰音、呼吸困难、发热)消失时间、住院时间及治疗前后血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果两组总有效率对比,联合药物治疗组(97.67%)优于单药治疗组(80.95%)(P<0.05);与单药治疗组比较,联合药物治疗组患儿的肺啰音、呼吸困难、发热消失时间及住院时间均较短(P<0.05);与治疗前比较,两组患儿治疗后的血清TNF-α、CRP、IL-6水平降低,且联合药物治疗组血清IL-6、CRP、TNF-α水平低于单药治疗组(P<0.05)。结论多巴酚丁胺与小剂量多巴胺联合治疗重症肺炎患儿的效果确切,能有效减轻患儿的炎症反应,缓解患儿的临床症状,促进患儿尽快康复。

Objective To investigate the therapeutic effect of low-dose dopamine combined with dobutamine on children with severe pneumonia.Methods A total of 85 children with severe pneumonia in Xuchang People’s Hospital from April 2018 to October 2019 were collected retrospectively and divided into combined drug treatment group(n=43)and single drug treatment group(n=42)according to drug treatment methods.Patients in both groups received routine symptomatic support treatment,and patients in the single drug treatment group were treated with dobutamine,and patients in the combined drug treatment group were treated with low-dose dopamine on the basis of the single drug treatment group.The curative effect,the disappearance time of clinical symptoms(crales,dyspnea,fever),length of hospitalization and serum levels of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)before and after treatment were compared between two groups.Results The total effective rate of the combined drug treatment group(97.67%)was more better than that of the single drug treatment group(80.95%)(P<0.05).Compared with the single drug treatment group,pulmonary rales,dyspnea,fever disappearance time and hospital stay were shorter in the combined drug treatment group(P<0.05).Compared with before treatment,the serum levels of IL-6,CRP and TNF-αafter treatment were lower in the two groups,and the serum levels in the combined drug treatment group were lower than those in the single drug treatment group(P<0.05).Conclusion The effect of dobutamine and low-dose dopamine in the treatment of children with severe pneumonia is definite,which can effectively reduce inflammatory reactions,relieve clinical symptoms,and promote the recovery.