小儿肺炎合并心力衰竭89例临床治疗分析

目的探讨米力农和多巴胺对肺炎合并心力衰竭(CHF)患儿的临床疗效。方法将89例患儿随机分为三组,A组为常规组,B组为米力农组0.75μg(/kg.min)],C组为多巴胺组5μg(/kg.min)],米力农和多巴胺采用微量泵泵入,3d后观察对比三组患儿的心率(HR)、血压(BP)、肺动脉压力(PAP)、中心静脉压(CVP)、B型尿钠肽(BNP)、左室射血分数(LVEF)、左室收缩时间间期(LVSTI)、右室射血分数(RVEF)、右室收缩时间间期(RVSTI)、副反应发生率。结果三组HR无统计学差异;组A的BP、LVEF明显低于组B和组C,组B的PAP、CVP和RVSTI明显低于组A和组C,组A的BNP明显高于组B和组C,组B的RVEF明显高于组C,组C的RVEF明显高于组A;结论米力农和多巴胺均能改善肺炎合并心力衰竭患儿的心功能,米力农对右心功能的改善较多巴胺更为明显。

Clinical Effect of Comprehensive Treatment on 89 Cases with Pediatric Pneumonia Complicated with Heart Failure

Objective To observe clinical effect of milrinone and dopamine on children suffering from pneumonia complicated with heart failure. Methods 89 patients were randomly divided into group A, group B（milrinone） and group C（ dopamine）.To observe the index varieties about heart rate（HR）, blood pressure（BP）, pulmonary artery pressure（PAP）, central venous pressure（CVP）, brain natriuretic peptide（BNP）, left ventricular ejection fraction（LVEF）, left ventricular systolic time interval（LVSTI）, right ventricular ejection fraction （RVEF）, right ventricular systolic time interval（RVSTI）, and side effect rate. Results HR of three groups had no statistical difference.BP and LVEF of group A were statisticaly lower than group B and group C. PAP, CVP and RVSTI of group B were statisticaly lower than group A and group C.BNP of group A was statisticaly higher than group B and group C. RVEF of group B was statisticaly higher than group C. RVEF of group C was statisticaly higher than group A. Conclusion Milrinone and dopamine have both obvious improvement on cardiac functions of children suffering from pneumonia complicated with heart failure, and milrinone is more effective than dopamine in improving the function of right heart.