纳洛酮联合地塞米松对重症肺炎伴心力衰竭患儿的疗效分析  

Analysis on curative effect of naloxone combined with dexamethasone in children patients with severe pneumonia complicating heart failure

作　　者：汤勉[1] 邱燕玲[1] 韩鹏[1] TANG Mian;QIU Yanling;HAN Peng(Department of Pediatric Intensive Care Medicine,Baoji Municipal Maternal and Child Health CareHospital,Baoji,Shaanxi 721000,China)

机构地区：[1]陕西省宝鸡市妇幼保健院儿童重症科,721000

出　　处：《检验医学与临床》2018年第20期3085-3088,共4页Laboratory Medicine and Clinic

摘　　要：目的对重症肺炎伴心力衰竭(简称心衰)肺炎患儿应用纳洛酮、地塞米松治疗的效果进行观察,并分析其对心功能、血气指标的影响。方法 92例重症肺炎伴心衰患儿随机分成观察组和对照组,各46例。对照组患儿在常规治疗基础上接受多巴胺、酚妥拉明治疗。观察组患儿在对照组基础上加用纳洛酮、地塞米松治疗。对两组患儿的临床治疗效果、临床症状缓解情况、治疗前后心率(HR)、呼吸频率(RR)、心功能指标[左室舒张末期半径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(LVSF)以及平均肺动脉压(MPAP)]、血气分析指标[动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、氧合指数(OI)]的变化情况及不良反应情况进行比较。结果经过相应的治疗之后,观察组患儿治疗的总有效率为91.3%,明显高于对照组的71.7%(P<0.05);观察组患儿的临床症状消失时间明显短于对照组(P<0.05);两组患儿的HR、RR水平均较治疗前显著下降,并且观察组患儿下降得更为明显(P<0.05);两组患儿的心功能指标均较治疗前显著改善,并且观察组患儿改善得更为明显(P<0.05);两组患儿的血气分析指标均较治疗前显著改善,并且观察组患儿改善得更为明显(P<0.05);两组患儿在治疗的过程中均未发生较为明显的不良反应。结论纳洛酮联合地塞米松应用于重症肺炎伴心衰患儿治疗,能够显著改善其HR、RR、心功能、血气指标,并且不会增加治疗的风险,安全性较高,具有积极的临床意义。Objective To observe the curative effect of naloxone combined with dexamethasone in children patients with severe pneumonia complicating heart failure,and to analyze its effects on cardiac function and blood gas indexes.Methods Ninety-two children patients with severe pneumonia complicating heart failure were randomly divided into the observation group and control group,46 cases in each group.The control group was treated with dopamine and phentolamine on the basis of routine treatment.On the basis of control group,the observation group was added with naloxone and dexamethasone treatment.The clinical treatment effect,clinical symptoms remission,changes of heart rate（HR）,respiratory rate（RR）,cardiac function indexes（LVEDD,LVEF,LVSF,MPAP）,blood gas analysis indexes（PaO2,PaCO2,OI）levels and adverse reactions were compared between the two groups.Results After the corresponding treatment,the total effective rate in the observation group was 91.3%,which was significantly higher than 71.7% in the control group（P〈0.05）.The disappearance time of clinical symptoms in the observation group was significantly shorter than that in the control group（P〈0.05）.The levels of HR and RR after treatment in the two groups were all significantly decreased compared with before treatment,moreover the decrease in the observation group was more significant（P〈0.05）.The cardiac function indexes after treatment in the two groups were all significantly improved compared with before treatment,and the improvement of the observation group was more significant（P〈0.05）.The blood gas analysis indexes of the two groups were all significantly improved compared with before treatment,moreover the observation group got more significant improvement（P〈0.05）.No more obvious adverse reactions occurred during the treatment in the two groups.Conclusion The application of naloxone combined with dexamethasone in the treatment of children patients with severe pneumonia complicating heart failure can significantly impro

关 键 词：重症肺炎 心力衰竭 纳洛酮 地塞米松 心功能 血气分析指标 

分 类 号：R541.62[医药卫生—心血管疾病]