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目的:探讨多巴胺联合酚妥拉明治疗小儿重症肺炎合并心力衰竭疗效及心肌酶学变化情况。方法:选择2014年10月至2015年3月之间于我院进行治疗的重症肺炎合并心力衰竭患儿185例作为研究对象随机分组。对照组92例患儿给予常规综合治疗,观察组93例患儿在此基础上给予多巴胺联合酚妥拉明治疗。比较两组患儿临床疗效、症状改善时间、治疗前后生命体征及心肌酶学指标变化情况以及不良反应发生情况。结果:观察组显效率及总有效率显著高于对照组,症状改善时间显著短于对照组,差异有统计学意义(P<0.05)。治疗前两组患儿生命体征及心肌酶学各项指标均无显著差异(P>0.05),治疗后两组患儿呼吸频率(HR)、心率(RR)显著下降,血氧饱和度(SpO_2)显著升高,心肌酶学各项指标均显著下降,差异较治疗前均有统计学意义(P<0.05)。组间比较,观察组患儿治疗后生命体征及心肌酶学各指标均明显优于对照组,差异有统计学意义(P<0.05)。两组患儿不良反应发生率无明显差异(P>0.05)。结论:多巴酚联合酚妥拉明治疗小儿重症肺炎合并心力衰竭具有良好的临床疗效及安全性,利于患儿临床症状及心肌损伤的恢复,值得临床推广应用。
Objective: To investigate the curative effect and changes of myocardial enzymes in children with severe pneumonia complicated with heart failure treated with dopamine and phentolamine. Methods: A total of 185 children with severe pneumonia complicated with heart failure who were treated in our hospital from October 2014 to March 2015 were randomly divided into two groups. Ninety-two children in the control group were given conventional comprehensive treatment, and 93 children in the observation group were treated with dopamine and phentolamine on the basis of the above. The clinical curative effect, the time of symptom improvement, the changes of vital signs and myocardial enzymological indexes before and after treatment and the incidence of adverse reactions were compared between the two groups. Results: The effective rate and total effective rate of the observation group were significantly higher than those of the control group, the symptom improvement time was significantly shorter than that of the control group, the difference was statistically significant (P <0.05). There were no significant differences in vital signs and myocardial enzymes between the two groups before treatment (P> 0.05). After treatment, respiratory rate (HR) and heart rate (RR) ) Were significantly increased, myocardial enzymes were significantly decreased in all indicators, the difference was statistically significant than before treatment (P <0.05). Compared between groups, vital signs and myocardial enzymes in observation group were significantly better than those in control group after treatment, the difference was statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). CONCLUSION: The combination of dobutamine and phentolamine in children with severe pneumonia complicated with heart failure has good clinical efficacy and safety, which is beneficial to the recovery of clinical symptoms and myocardial injury in children, and worthy of clinical application.