多巴胺联合酚妥拉明治疗儿科急诊重症肺炎合并心力衰竭的效果  

Efficacy of Dopamine Combined with Phentolamine in the Treatment of Pediatric Emergency Severe Pneumonia with Heart Failure

作　　者：赵阳[1] ZHAO Yang(Shouguang Maternal and Child Health Care Hospital,Shouguang 262700,China)

机构地区：[1]寿光市妇幼保健院,山东寿光262700

出　　处：《中华灾害救援医学》2024年第11期1339-1341,1345,共4页Chinese Journal of Disaster Medicine

摘　　要：目的分析对于重症肺炎合并心力衰竭患儿采用多巴胺联合酚妥拉明治疗的临床效果。方法对2023年3月至2024年3月寿光妇幼保健院收治的106例重症肺炎合并心力衰竭患儿的临床资料进行回顾性分析,根据治疗方案的不同分为研究组(采用多巴胺联合酚妥拉明治疗)和对照组(仅用酚妥拉明治疗),每组各53例。对比两组患儿的临床症状改善时间、心功能指标、心肌酶谱水平、临床疗效、不良反应发生情况。结果治疗后,与对照组患儿相比,研究组患儿的喘息消失时间、咳嗽消失时间、肺湿啰音消失时间、呼吸恢复正常时间、心率恢复正常时间、心力衰竭纠正时间均更短(P<0.001)。治疗后,两组患儿的左心室射血分数(Left Ventricular Ejection Fraction,LVEF)水平均升高,左心室舒张末期容量(Left Ventricular End Diastolic Volume,LVEDV)水平均降低;且与对照组患儿相比,研究组患儿LVEF水平更高,LVEDV水平更低(P<0.001)。治疗后,与对照组患儿相较,研究组患儿乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶水平降低更显著(P<0.001),且研究组患儿的临床总有效率较对照组更高(P<0.05),但两组患儿不良反应总发生率无明显差异(P>0.05)。结论对于重症肺炎合并心力衰竭的患儿,给予多巴胺联合酚妥拉明进行治疗可有效缩短临床症状改善时间,改善心功能,减轻心肌损伤程度,临床疗效显著,且安全性较高。Objective To analyze the effect of a dopamine combined with phentolamine treatment regimen in children with severe pneumonia complicated by heart failure.Methods A retrospective analysis was conducted on the clinical data of 106 children with severe pneumonia and heart failure admitted to Shouguang Maternal and Child Health Hospital from March 2023 to March 2024.Based on the treatment regimens,patients were divided into the study group(dopamine combined with phentolamine)and the control group(phentolamine alone).Clinical symptom improvement time,heart function indicators,myocardial enzyme levels,clinical efficacy,and the incidence of adverse reactions were compared between the two groups.Results Compared to the control group,the study group showed significantly shorter times for the disappearance of wheezing,cessation of cough,resolution of lung crackles,normalization of breathing,normalization of heart rate,and correction of heart failure(P<0.001).After treatment,both groups showed an increase in left ventricular ejection fraction(LVEF)and a decrease in left ventricular end-diastolic volume(LVEDV).The study group demonstrated significantly higher LVEF and lower LVEDV levels than the control group(P<0.001).Additionally,the levels of lactate dehydrogenase(LDH),creatine kinase(CK),and creatine kinase MB isoenzyme(CK-MB)decreased more significantly in the study group compared to the control group(P<0.001).The overall clinical efficacy in the study group was higher than in the control group(P<0.05),with no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Dopamine combined with phentolamine therapy for children with severe pneumonia complicated by heart failure can effectively shorten the time for clinical symptom improvement,enhance heart function,reduce myocardial injury,and provide significant clinical benefits with a high safety profile.

关 键 词：多巴胺 酚妥拉明 肺炎 心力衰竭 医院 儿科 

分 类 号：R720.597[医药卫生—急诊医学]