东莨菪碱治疗小儿多器官功能障碍综合征的临床效果

目的探讨东莨菪碱治疗小儿多器官功能障碍综合征（MODS）的临床效果。方法对本院2009年3月-2014年3月收治的60例小儿MODS患者进行研究，将患者随机分为东莨菪碱治疗组（n=32）和常规治疗组（n=28）。常规治疗组采用常规方法治疗，东莨菪碱治疗组在常规治疗的基础上采用东莨菪碱治疗。比较两组患者的动脉血乳酸、平均动脉压、氧合指数、器官衰竭评分、小儿危重病评分以及病死率等。结果治疗后，两组的氧合指数和平均动脉压均升高，两组治疗后的上述指标比较差异有统计学意义（P〈0．05）；治疗6h后，东莨菪碱治疗组的动脉血乳酸得到有效改善，对照组改善不明显，两组治疗后的动脉血乳酸比较，差异有统计学意义（P〈0．05）。治疗后，两组的器官衰竭评分均明显下降，两组治疗后的器官衰竭评分比较，差异有统计学意义（P〈0．05）；治疗后，两组的小儿危重病评分均明显升高，两组治疗后的小儿危重病评分差异有统计学意义（P〈0．05）；东莨菪碱治疗组的病死率为16．7％，低于常规治疗组的37.3％（P〈0．05）。结论在常规治疗的基础上配合使用东莨菪碱可有效提高治疗效果，提高平均动脉压、氧合指数，改善动脉血乳酸，有效降低死亡率。

Clinical effect of scopolamine treating multiple organ dysfunction syndrome in children

Objective To investigate clinical effects of scopolamine treating multiple organ dystunction syndrome （MOD3） in children. Methods 60 children with MODS treated in our hospital from March 2009 to March 2014 were studied,and they were randomly divided into the scopolamine treatment group （n=32） and the routine treatment group （n=28）.The routine treatment group was treated with the routine treatment method while the scopolamine treatment group was treated with scopolamine.Arterial blood lactic acid,mean arterial pressure,oxygenation index,organ failure score,pediatric critical illness score and mortality of the two groups were compared. Results After treatment,oxygenation index and mean arterial pressure of the two groups were increased,and there was a statistical difference of the indicators abovementioned in the two groups （P〈0.05） after treatment,after 6 hours treatment,arterial blood lactic acid in the scopolamine treatment group was improved effectively,but the improvement of arterial blood lactic acid in the routine group was not obvious,and there was a statistical difference of arterial blood lactic acid between the two groups after treatment （P〈0.05）.After treatment,organ failure score of the two groups was obviously decreased and there was a statistical difference of organ failure score of the two groups （P〈0.05） after treatment,pediatric critical illness score of the two groups were increased significantly,and there was a statistical difference of pediatric critical illness score in the two groups （P〈0.05）; after treatment,mortality of the scopolamine treatment group （16.7%） was lower than that in the in the routine treatment group （37.3%） （P〈0.05）. Conclusion On the basis of the routine treatment,adding scopolamine can effectively improve the therapeutic effectand can improve the mean arterial pressure,improve arterial blood lactic and can reduce mortality.