早期小剂量多巴胺联合纳洛酮治疗小儿重症肺炎的效果观察  

Observation on the effect of early low-dose dopamine combined with naloxone in treatment of severe pneumonia in children

作　　者：官素玲 李剑芳[1] 段锦辉 李雪红[2] 

机构地区：[1]韶关市始兴县人民医院儿科,广东韶关512500 [2]暨南大学,广东广州510632

出　　处：《中国妇幼保健》2017年第23期5924-5927,共4页Maternal and Child Health Care of China

摘　　要：目的探析早期小剂量多巴胺联合纳洛酮治疗小儿重症肺炎的疗效及安全性。方法前瞻性选择始兴县人民医院儿科2014年1月-2015年6月收治的120例确诊为重症肺炎小儿患儿投掷硬币法分为治疗组和对照组各60例,对照组患儿在常规治疗基础上加用纳洛酮,治疗组患儿在对照组用药基础上加用微量泵泵注小剂量多巴胺,对比两组患儿临床症状和体征改善情况、炎症因子水平、疗效及不良反应情况。结果治疗组患儿临床症状和体征改善时间明显短于对照组患儿,差异有统计学意义(P<0.05);两组患儿治疗后IL-6、TNF-α、IL-10水平较治疗前均明显下降,治疗组IL-6、TNF-α下降水平较对照组更明显,IL-10下降水平没有对照组明显仍保持高水平,差异均有统计学意义(P<0.05)。治疗组治愈率、总有效率分别为66.67%、91.67%明显高于对照组的38.33%、78.33%,差异均有统计学意义(P<0.05)。均未发生严重的不良反应。结论小剂量多巴胺联合纳洛酮治疗小儿重症肺炎可明显改善炎症因子水平,疗效确切,不良反应少且轻微,可作为临床首选治疗方案之一。Objective To explore the efficacy and safety of early low-dose dopamine combined with naloxone in treatment of children with severe pneumonia. Methods A total of 120 children diagnosed as severe pneumonia definitely in Department of Pediatrics in Shixing County People＇s Hospital were selected and randomly divided into treatment group and control group, 60 children in each group. The children in control group were treated by conventional therapy combined with naloxone, and the children in treatment group were treated by conven- tional therapy, naloxone, and low-dose dopamine. The improvements of clinical symptoms and signs, the levels of inflammatory cytokines, curative effects, and adverse reactions in the two groups were compared. Results The improvement time of clinical symptoms and signs in treatment group was statistically significantly shorter than that in control group （P〈 0. 05 ） . After treatment, the levels of interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α）, and interleukin-10 （IL-10） in the two groups decreased significantly; the decreasing levels of IL-6 and TNF-α in treatment group were more significant compared with control group, while the decreasing level of IL-10 in treatment group was not more significant compared with control group, there were statistically significant differences （P〈0. 05） . The cure rate and to- tal effective rate in treatment group were 66. 67% and 91.67%, respectively, which were statistically significantly higher than those in con- trol group （38.33% and 78.33% ） （P〈0. 05） . No serious adverse reactions occurred. Conclusion Low-dose dopamine combined with naloxone can significantly improve the levels of inflammatory cytokines in treatment of severe pneumonia in children, the clinical effect is good, the adverse reactions are less and mild, which can be used as the first choice therapy.

关 键 词：小儿 重症肺炎 多巴胺 纳洛酮 治疗效果 

分 类 号：R725.6[医药卫生—儿科]