硝普钠联合米力农治疗伴循环不良的危重症手足口病临床疗效

目的探讨硝普钠联合米力农治疗危重症手足口病并循环不良的临床疗效。方法对25例收治的伴有循环不良的危重症手足口病患儿,采用对照分析方法,设置治疗组与对照组,治疗组15例,对照组10例。两组患儿均予机械通气、静脉用丙种球蛋白(IVIG)、甲基泼尼松龙、20%甘露醇、甘油果糖降颅压等基础治疗。治疗组加用硝普钠联合米力农静脉滴注治疗,硝普钠剂量1.0～2.0μg/(kg.min),同时予米力农首剂25～50μg/kg缓慢静注后0.25μg/(kg.min)静推泵维持。对照组予肾上腺素0.3～0.5μg/(kg.min)和多巴胺3.0～6.0μg/(kg.min)静脉维持。结果与对照组相比,硝普钠联合米力农对危重症手足口病患儿血压、心率、四肢皮温、皮肤颜色、脉搏的疗效显著(P<0.05)。结论硝普钠联合米力农治疗伴有循环不良的重症手足口病患儿,循环改善快,疗效好,不良反应少。

Clinical Curative Effect of Sodium Nitroprusside Combined Milrinone on Patients with Severe Hand-Foot-Mouth Disease and Poor Circulation

Objective To explore the curative effect of sodium nitroprusside combined milrinone on patients with severe hand-foot-mouth disease and poor circulation.Methods The contrastive analysis was conducted in 25 cases with severe hand-foot-mouth disease and poor circulation to divide them into treatment group(15 cases) and control group(10 cases).The patients in both groups were treated with mechanical ventilation,intravenous immunoglobulin(IVIG),methylprednisolone,20% mannitol,glycerol and fructose which can reduce the intracranial pressure.The treatment group received also intravenous drip of sodium nitroprusside 1.0-2.0 μg/(kg·min) combined with first dose of 25-50 μg/kg milrinone followed by 0.25 μg/(kg·min) intravenous injection pump maintenance.The control group received intravenous epinephrine 0.3-0.5 μg/(kg·min) and dopamine 3.0-6.0 μg/(kg·min).Results Compared with the control group,the curative effects of sodium nitroprusside combined with milrinone was significant on the blood pressure,heart rate,skin temperature,skin color,limbs pulse in patients with severe hand-foot-mouth disease and poor circulation(P<0.05).Conclusion For the patients with severe hand-foot-mouth disease and poor circulation,Sodium nitroprusside combined with milrinone,with better effect and less adverse reaction,can effectively improve their circulation.