Analysis of the clinical effect of small dose dopamine combined with dobutamine in children with severe pneumonia
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摘要: 目的 探讨采用小剂量多巴胺联合多巴酚丁胺对重症肺炎患儿血清学指标、临床症状改善的影响及临床疗效和安全性,为临床治疗提供指导。 方法 选取2012年2月—2015年6月就诊的重症肺炎患儿121例作为研究对象,随机分为对照组和观察组;对照组患儿59例,采用常规的抗感染、吸氧、保持呼吸道通畅等对症治疗,观察组患儿62例,在抗感染、吸氧、保持呼吸道通畅的基础上,采用小剂量多巴胺联合多巴酚丁胺治疗,检测患儿治疗前后血清炎症因子水平、免疫因子水平等血清学变化,记录患儿临床症状改善状况,评定临床疗效及并发症状况。 结果 2组患儿在治疗前炎症因子水平和免疫因子水平方面差异无统计学意义(P>0.05),治疗前后炎症因子水平和免疫因子水平均存在显著变化(P<0.01);在治疗效果上,2组患儿差异有统计学意义(Z=-2.169,P=0.03<0.05);2组患儿临床症状改善时间差异有统计学意义(P<0.01),对照组患儿治疗期间呼吸困难频率、咳嗽频率为(2.15±0.94)、(6.94±1.76)次/d,观察组患儿治疗期间呼吸困难频率、咳嗽频率为(1.19±0.53)、(4.31±1.25)次/d,差异有统计学意义(P<0.01);对照组3例发生恶心呕吐,观察组2例出现恶心呕吐,2组差异无统计学意义(P>0.05),经处理后症状消失。 结论 对重症肺炎患儿采用小剂量多巴胺联合多巴酚丁胺能显著缓解缺氧状态,治疗效果显著,临床症状改善时间短,安全性高,值得推广。Abstract: Objective To explore the clinical effect of small dose dopamine combined with dobutamine in children with severe pneumonia serological indicators,improve clinical symptoms and clinical efficacy and safety,for the clinical treatment to provide guidance. Methods One hundred and twenty-one children with severe pneumonia were selected from February 2012 to June 2015 in my courtyard department of pediatrics ward.The children were randomly divided to observation group and control group.Patients in the control group(59 cases) were treated with conventional anti infection,oxygen inhalation,keep respiratory tract unobstructed and symptomatic treatment,the research group (62 cases),on the basis of conventional therapy,were treated with small dose dopamine combined with dobutamine,observation and analysis in serologic changes in two groups before and after treatment in children with serum levels of inflammatory factors and immune factor level,records of children with clinical symptoms to improve the situation,assess clinical effect and complication of the situation. Results There were no difference in the pro-inflammatory cytokine levels and the levels of immune factors between the two groups of children before the treatment(P>0.05).However,the levels of the inflammatory cytokines and immune factors were significant changes after treatment(P<0.01).In the effect of treatment,the two groups are different(Z=-2.169,P=0.03<0.05) in the recovery time,breathing improvement,heart rate improvement time,three concave syndrome improvement,there are significant differences on pulmonary rate (P<0.01).Dyspnea frequency and cough frequency of the control group during the treatment were (2.15±0.94)d and (6.94±1.76) times/d,the same indexes of the patients in the observation group during the treatment were (1.19±0.53)d and (4.31±1.25) times/d,there were significant differences between them(P<0.01);in the control group,3 cases of nausea and vomiting,2 cases in observation group were nausea and vomiting.No difference(P>0.05),after adjusting the infusion speed to alleviate the symptoms completely disappeared after the transfusion. Conclusion Small dose dopamine combined with dobutamine treatment of severe pneumonia in children has significant effect,could improve clinical symptoms at short time,with high safety,worthy of promotion.
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Key words:
- Dopamine /
- Dobutamine /
- Severe pneumonia /
- Serology
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