小儿重症肺炎并呼吸衰竭予小剂量多巴胺、多巴酚丁胺联合酚妥拉明治疗的临床疗效研究

目的:探讨小儿重症肺炎并呼吸衰竭患儿予小剂量多巴胺、多巴酚丁胺联合酚妥拉明治疗的临床疗效及应用价值。方法:选取2015年1月～2016年5月期间我院收治的重症肺炎合并呼吸衰竭患儿118例为研究对象,按照数字表法,分为观察组(n=60)与对照组(n=58),两组均给予持续静脉泵入多巴胺、多巴酚丁胺治疗,观察组在常规治疗基础上,加用酚妥拉明治疗,比较两组临床疗效、体温消观时间、心率恢复正常时间、肺部观音消失时间、血气分析指标的改善、危重病例评分的提高等。结果:观察组治疗总有效率93.33%(56/60),明显高于对照组总有效率81.03%(47/58),差异显著具有统计学意义(P<0.05);观察组体温消观时间、呼吸困难缓解时间、心率恢复正常时间及肺部观音消失时间明显短于对照组,差异具有统计学意义(P<0.05);观察组治疗后血气分析主要指标的改善情况及危重病例评分的提高均明显优于对照组,差异显著,具有统计学意义(P<0.05)。结论:在小儿重症肺炎合并呼吸衰竭的治疗上,小剂量多巴胺、多巴酚丁胺联合酚妥拉明治疗临床效果明显、方法简单、价格低廉,值得临床广泛推广应用。

Objective: To investigate the clinical effect and application value in the treatment of the children with severe pneumonia and respiratory failure who were treated with small dose of dopamine and dobutamine combined with phentolamine. Methods: 118 children cases of severe pneumonia complicated with respiratory failure in our hospital from January 2015 to 2016 in May were selected as the object of study, and in accordance with the number table method, they were divided into the observation group(n=60) and control group(n=58), both treated with continuous intravenous infusion of dopamine and dobutamine. On the basis of routine treatment, the observation group was treated with phentolamine, compared of two groups in the clinical efficacy, the subsided time of body temperature, the recovery time of heart rate, the disappeared time of pulmonary rale, improvement of blood gas analysis index and improvement of critical cases score. Results: the total treatment efficiency of the observation group was 93.33%(56/60), which was significantly higher than that of the control group 81.03%(47/58), and the difference was statistically significant(P < 0.05); The fever subsided time, dyspnea remission time, heart rate recovery time and pulmonary rales disappeared time in the observation group was shorter than that in the control group, and the difference was statistically significant(P < 0.05); The improvement of the main indexes of blood gas analysis and the improvement of the critical cases score after treatment in the observation group were significantly better than those in the control group, and the difference was statistically significant(P < 0.05). Conclusion: In the treatment of children with severe pneumonia complicated with respiratory failure, the treating of a small dose of dopamine and dobutamine combined with phentolamine has remarkable clinical effect and low price and the method is simple, so it is worthy of wider clinical application.