酚妥拉明不同给药方式治疗支气管肺炎合并心力衰竭患儿疗效观察

摘要

目的 观察酚妥拉明2种给药方法治疗小儿支气管肺炎合并充血性心力衰竭的临床疗效.方法 选取解放军第二五二医院儿科2008年1月至2012年11月治疗的81例小儿支气管肺炎合并充血性心力衰竭患者,完全随机分为酚妥拉明入壶组(24例)、酚妥拉明持续泵入组(30例)和对照组(27例)所有患者给予抗感染、平喘、强心常规治疗,酚妥拉明入壶组采用传统方法酚妥拉明0.5 mg/kg入莫菲滴壶静脉滴注,酚妥拉明持续泵入组采用输液泵静脉滴注,速度为0.6 ～1 μg/(kg·min),疗程均为3 cd观察3组患者临床疗效、咳嗽消失时间、喘息消失时间和肺部哆音消失时间及不良反应.结果 酚妥拉明入壶组与酚妥拉明持续泵入组比较,咳嗽消失时间差异无统计学意义(P＞0.05),喘息消失时间和肺部哕音消失时间比较差异有统计学意义[(6.8±1.1)d比(5.9±0.8)d,(6.8±0.9)d比(6.3±0.9)d,均P＜0.05].酚妥拉明入壶组与酚妥拉明持续泵入组总有效率比较,差异有统计学意义[91.7％ (22/24)比96.7％(29/30)P＜0.05.2组分别与对照组[85.2％(23/27)]比较,差异有统计学意义,(P＜0.05)结论 酚妥拉明以输液泵静脉滴注治疗小儿支气管肺炎合并充血性心力衰竭,肺部哕音和咳喘消失时间缩短,且无鼻阻、烦躁、心率增快等不良反应出现.%Objective To observe the clinical curative effect in children's bronchitis pneumonia accompanied with cardiac failure by the treatment of the two different methods of abstention with phentolamine.Methods Eighty-one cases in children's pneumonia accompanied with cardiac failure were stochastically divided into treatment group 1(24 cases,treated by infusion with phentolamine) and treatment group 2(30 cases treated by continuos pump with phentolamine) and control group(27 cases,without phentolamine).The control group was conventionally treated by anti-infection,antiasthmatic effect and cardiac strength.Based on the treatment above,treatment group 1 took the intravenous injection into murph's dropper with phentolamine,and group 2 took the intravenous infuseion with phentolamine.The clinical efficacy of the three groups of patients,cough disappearance time,wheezing disappearance time,pulmonary rales disappeared time and adverse reactions were observed.Results Cough disappearance time had no significant difference in treatment group 1 and treatment group 2.Wheezing disappeared time and pulmonary rales disappeared time in the treatment group 2 were shorter than those in the treatment group 1 [(5.9±0.8)d vs (6.8±1.1)d,(6.3±0.9)dvs (6.8±0.9)d,P＜0.05].Effective rate in the treatment group 2 was higher than that in the control group and treatment group 1 [96.7％ (26/30) vs 91.7％ (22/24),85.2％ (23/27)]; effective rate in the treatment group 1 was higher than that in the control group; differences were statistically significant(all P ＜0.05).Conclusions Children with bronchial pneumonia and congestive heart failure treated by intravenous drip infusion pump phentolamine,wheezing disappeared time and pulmonary rales disappeared time are shortened.There are no adverse reactions such as nasal resistance,irritability,increased heart rate.