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目的探讨硝普钠联合米力农治疗危重症手足口病并循环不良的临床疗效。方法对25例收治的伴有循环不良的危重症手足口病患儿,采用对照分析方法,设置治疗组与对照组,治疗组15例,对照组10例。两组患儿均予机械通气、静脉用丙种球蛋白(IVIG)、甲基泼尼松龙、20%甘露醇、甘油果糖降颅压等基础治疗。治疗组加用硝普钠联合米力农静脉滴注治疗,硝普钠剂量1.0～2.0μg/(kg.min),同时予米力农首剂25～50μg/kg缓慢静注后0.25μg/(kg.min)静推泵维持。对照组予肾上腺素0.3～0.5μg/(kg.min)和多巴胺3.0～6.0μg/(kg.min)静脉维持。结果与对照组相比,硝普钠联合米力农对危重症手足口病患儿血压、心率、四肢皮温、皮肤颜色、脉搏的疗效显著(P<0.05)。结论硝普钠联合米力农治疗伴有循环不良的重症手足口病患儿,循环改善快,疗效好,不良反应少。
Objective To investigate the clinical effects of sodium nitroprusside combined with milrinone in the treatment of critically ill hand-foot-mouth disease and poor circulation. Methods 25 cases of children with critically ill hand-foot-mouth disease who had poor circulatory insufficiency were enrolled in this study. The control group and the control group were given 15 cases in the treatment group and 10 cases in the control group. Two groups of children were given mechanical ventilation, intravenous gamma globulin (IVIG), methylprednisolone, 20% mannitol, glycerol fructose intracranial pressure and other basic treatment. The treatment group was treated with intravenous injection of sodium nitroprusside and milrinone, and the dose of sodium nitroprusside was 1.0-2.0μg / (kg · min) (kg.min) static pump to maintain. The control group was given epinephrine 0.3 ~ 0.5μg / (kg · min) and dopamine 3.0 ~ 6.0μg / (kg.min) intravenous maintenance. Results Compared with the control group, the effects of sodium nitroprusside and milrinone on blood pressure, heart rate, limb skin temperature, skin color and pulse in critically ill hand-foot-mouth disease were significant (P <0.05). Conclusion Sodium nitroprusside combined with milrinone treatment of patients with severe circulatory dysfunction with circulatory dysfunction, rapid improvement, good efficacy, fewer adverse reactions.