本文選題：米力農(nóng)　切入點(diǎn)：霧化療法　出處：《中華醫(yī)院感染學(xué)雜志》2017年21期

【摘要】：目的探討米力農(nóng)霧化療法在重癥肺部感染并發(fā)心力衰竭兒童中的應(yīng)用效果,為臨床治療提供理論依據(jù)。方法選擇2013年6月-2016年6月醫(yī)院就診的重癥肺部感染并發(fā)心力衰竭患兒86例,按照隨機(jī)數(shù)表法將患兒分為研究組和對(duì)照組,各43例,對(duì)照組患兒給予基礎(chǔ)治療,研究組在對(duì)照組的基礎(chǔ)上給予米力農(nóng)霧化療法,觀測(cè)兩組患兒治療前后的心率、面色轉(zhuǎn)紅潤(rùn)時(shí)間、精神狀況、肺部Up音消失時(shí)間、哺乳時(shí)間、肝臟縮小時(shí)間等體征情況;比較兩組患兒癥狀、體征改善時(shí)間、治療有效率,觀察并記錄兩組患兒藥物副作用,測(cè)量?jī)山M患兒左室收縮末徑(LVSD)、左室舒張末徑(LVDD)、房室瓣EA峰比值(E/A)、左室短軸縮短率(LVSF)、動(dòng)脈收縮壓(SAP)、平均肺動(dòng)脈壓(MPAP)、氧合指數(shù)(OI)。結(jié)果研究組患者面色轉(zhuǎn)紅潤(rùn)41例占95.35%、肝臟回縮41例占95.35%、哺乳時(shí)間縮短40例占93.02%、濕Up音消失41例占95.35%、煩躁消失39例占90.70%,顯著高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者病原菌檢測(cè)共檢測(cè)出147株病原菌,其中檢測(cè)出革蘭陰性菌86株,占58.50%,革蘭陽(yáng)性菌53株,占36.05%,真菌8株,占5.45%;治療后,研究組LVSF、LVEF、E/A、SAP水平高于對(duì)照組,LVDD、LVSD、MPAP、OI等低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),研究組患者治療有效率為95.35%,對(duì)照組患者治療有效率為81.40%,顯著低于研究組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論米力農(nóng)霧化療法能夠顯著縮短重癥肺部感染并發(fā)心力衰竭兒童體征癥狀改善時(shí)間,有效改善其心功能,提高治療有效率,且具有較好的安全性,值得臨床推廣。
[Abstract]:Objective to investigate the efficacy of milrinone atomization therapy in children with severe pulmonary infection complicated with heart failure. Methods 86 children with severe pulmonary infection complicated with heart failure from June 2013 to June 2016 were selected and divided into study group and control group according to random number method. Children in the control group were given basic treatment, and the study group was given milrinone atomization therapy on the basis of the control group. The heart rate, turning ruddy time, mental condition, disappearance time of lung up sound, lactation time before and after treatment were observed in the two groups. The symptoms, improvement time, effective rate of treatment were compared between the two groups, and the side effects of drugs were observed and recorded in the two groups. Left ventricular end systolic diameter (LVSD), left ventricular end diastolic diameter (LVDDD), atrial ventricular valve EA peak ratio (E / A), left ventricular short axis shortening rate (LVSFN), arterial systolic pressure (SAP), mean pulmonary artery pressure (MPAP), oxygenation index (Oi) were measured in both groups. 41 cases had liver retraction, 40 cases had shorter lactation time (93.02%), 41 cases had lost wet up sound (95.35%), 39 cases had restlessness (90.70%), which was significantly higher than that in control group. A total of 147 strains of pathogenic bacteria were detected in the two groups, of which 86 were gram-negative bacteria (58.50), 53 were gram-positive bacteria (36.05), 8 were fungi (5.45g). Compared with the control group, the level of LVSFFV E / Agna SAP in the study group was higher than that in the control group. The difference was statistically significant (P 0.05). The effective rate of treatment was 95.3535 in the study group and 81.40 in the control group, which was significantly lower than that in the study group. Conclusion Milinon atomization therapy can significantly shorten the time of symptom improvement in children with severe pulmonary infection complicated with heart failure, improve the heart function, improve the effective rate, and have better safety. It is worth popularizing in clinic.
【作者單位】： 南陽(yáng)市中心醫(yī)院兒科;
【分類號(hào)】：R725

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