米力农对合并心力衰竭老年肺炎患者血气分析和心功能的影响

目的：探讨米力农对合并心力衰竭老年肺炎患者血气分析和心功能的影响.方法：90例合并心力衰竭老年肺炎患者随机分为对照组和观察组.对照组给予氧疗、抗感染、强心和稀释痰液、呼吸支持、营养支持等常规治疗,观察组在常规治疗基础上予米力农注射液10～15 mg加入50 ～ 100 ml氯化钠注射液中,0.5 μg·kg-·min-泵入,qd,5d为1个疗程.比较两组治疗前后血气分析、C-反应蛋白（CRP）、心脏射血分数（EF％）、心功能分级改善率、平均住院时间、病死率及不良反应发生率.结果：治疗后两组患者的动脉氧分压（PaO2）、pH、动脉血氧饱和度（SaO2）、EF％均较治疗前明显增加,CRP则明显下降（P＜0.05）,且观察组优于对照组（P＜0.05）.治疗后观察组心功能改善有效率达91.1％,明显高于对照组的68.8％（P＜0.05）;观察组住院时间较对照组短（P＜0.05）;两组病死率差异无统计学意义（P＞0.05）.结论：米力农治疗合并心力衰竭老年肺炎可明显改善改善心肺功能,提高氧合,缩短住院时间,安全性较好,值得临床应用.

Blood gas and Cardiac Function Effects of Milrinone in the Treatment of Elderly Patients with Pneumonia Combined with Heart Failure

Objective：To explore the blood gas and cardiac function effect of milrinone in the treatment of elderly patients with pneumonia combined with heart failure.Methods：Totally 90 cases of elderly patients with pneumonia combined with heart failure from January 2010 to June 2013 were randomly divided into the control group and the treatment group.The control group was given such conventional treatment as oxygen therapy,anti-infection,cardiotonic therapy,sputum dilution,respiratory support and nutritional support.The treatment group was given 10-15mg milrinone in 50-100ml normal saline using micro-pump injection additionally with the injection speed was 0.5 μg· kg-1 · min-1,once a day,and the treatment course was 5 days.Before and after the treatment,the blood gas,C-reactive protein（CRP）,cardiac ejection fraction（EF％）,cardiac function grading period,the average length of hospital stay,fatality rate and adverse reactions were analyzed and compared in the two groups.Results：After the treatment,the blood PaO2,pH,SaO2 and EF％ were increased while CRP was declined in the two groups after the treatment （P ＜ 0.05）,and the changes in the treatment group were more significant than those in the control group （P ＜0.05）.The improvement rate of cardiac functional grading in the treatment group was 86.7％,which was higher than that （68.8％） in the control group.The average length of hospital stay was （14.6 ±4.6） days in the treatment group,while that was （17.4 ± 5.7） days in the control group （P ＜ 0.05）.The fatality rate was 11.11％ in the treatment group,while that was 20.00％ in the control group.There were few and mild adverse reactions in the two groups.Conclusion：Milrinone used in elderly patients with pneumonia combined with heart failure can greatly improve the cardiopulmonary function and oxygenation,and reduce the length of hospital stay with promising safety,which is worthy in clinical application.