酚妥拉明对肺炎患儿的血气影响和临床作用

The Clinical Effect and the Influence on Blood Gases of Regitine in the Children with Pneumonia

为了正确认识全身应用扩血管药的临床作用 ,本作者给 2 8名典型支气管肺炎患儿静脉滴入酚妥拉明 ( 8ug/kg/分 ) 2 0分钟观察血气变化和临床副作用的发生率 ,结果显示 :酚妥拉明使PaO2 从 66.70± 10 .60mmHg降至 62 .6± 11.5 6mmHg(P <0 .0 1) ,SaO2 从 91.3 0± 3 .63 %降至 88.10± 4.71% (P <0 .0 1)、PCO2 从 3 5 .42± 5 .5 3mmHg升至 3 6.43± 5 .88mmHg(P >0 .0 5 ) ;临床上不同比例发生心率增快 ,鼻阻、头昏、腹痛、呕吐。用酚妥拉明后鼻阻组与非鼻阻组血气改变无显著性差异 (P >0 .0 5 ) ,提示 :酚妥拉明是一种非选择性扩血管药 ,可能加重已经存在的通气 /血流比失调 ,使血气恶化 ,并产生较多的临床副作用。今后在肺部疾病患者的扩血管剂的选择上应着重于它是否能选择性扩张通气好的肺泡外血管 。

to assess the clinical effects of non_selective systemic vasodilatior on patients with pneumonia, the authors infused Regitine into 28 children with pneumonia to monitor blood gases changes and clinical side_effects. The blood gases showed a significant decrease in PaO 2 and SaO 2(P<0.01) and an insignificant increase in PaCO 2(P>0.05);There manifested some side effects, including tachycardia, nose stuff, dizziness, stomach_ache and vomiting. These suggest that Regitine is a non_selective vasodilator which worsens hypoxemia and leads to some side-effects. Therefore, we suggest to restrict the use of non_selective vasodilators in pediatric pulmonary diseases in which ventilation/ perfusion mismatch is already profound and call for the use of selective, inhaled agents like Nitric Oxide.