多巴胺（小劑量）、多巴酚丁胺、常規方案聯合治療重癥新生兒感染性肺炎的臨床評估

林玉平　郭永新　吳雪華　胡麗風

【摘要】 目的：分析探討重癥新生兒感染性肺炎患兒采取多巴胺（小劑量）、多巴酚丁胺聯合常規治療的臨床效果及相關指標的改變。方法：選擇筆者所在醫院2015年7月-2016年12月收治入院的重癥新生兒感染性肺炎患兒300例，根據治療方法的不同分為兩組，對照組150例患兒采取常規治療，觀察組150例患兒在此基礎上聯合小劑量多巴胺及多巴酚丁胺進行治療，分析對比兩組患兒的臨床治療效果及相關指標的改變。結果：經治療后，兩組患兒的動脈氧分壓（PaO2）、動脈血氧飽和度（SaO2）和氧合指數（PaO2/FiO2）等血氣指標數據均顯著升高，相比對照組，觀察組各項指標改善程度明顯較優，組間比較差異有統計學意義（P<0.05）。經治療后，對照組患兒死亡10例，死亡率為6.6%，總有效率為66.7%。而觀察組無死亡人數，總有效率為93.3%。結論：重癥新生兒感染性肺炎會引發多系統的病變和障礙，造成患兒難以挽回的損失，而采取常規治療聯合小劑量多巴胺及多巴酚丁胺對重癥新生兒感染性肺炎患兒進行治療，能顯著改善患兒的感染情況，促進機體系統的恢復，從而取得了更好的臨床效果，適合在臨床上廣泛推廣和應用。

【關鍵詞】 重癥新生兒感染性肺炎； 多巴胺； 多巴酚丁胺； 常規治療

doi：10.14033/j.cnki.cfmr.2017.29.002 文獻標識碼 A 文章編號 1674-6805（2017）29-0003-03

Clinical Evaluation of Dopamine（Low Dose），Dobutamine and Conventional Therapy in the Treatment of Severe Neonatal Infectious Pneumonia/LIN Yu-ping，GUO Yong-xin，WU Xue-hua，et al.//Chinese and Foreign Medical Research，2017，15（29）：3-5

【Abstract】 Objective：To investigate the clinical effect of Dopamine（low dose），Dobutamine combined with conventional treatment for the severe neonatal pneumonia and related index changes.Method：From July 2015 to December 2016，300 cases of pneumonia infection in our hospital Neonates，according to the different treatment methods were divided into two groups，the control group of 150 patients received conventional treatment，the observation group of 150 cases on the basis of this combined with small dose of Dopamine and Dobutamine for treatment，analysis of clinical treatment of the two groups were compared and related index changes.Result：After the treatment，two arterial oxygen partial pressure（PaO2），arterial oxygen saturation（SaO2） and oxygenation index（PaO2/FiO2） and blood gas data were significantly higher than before treatment，the indicators of the observation group improved significantly better than the control group，the differences were statistically significant（P<0.05）.After the treatment，the patients in the control group 1 case died，the mortality rate was 6.6%，the total effective rate was 66.7%，and the observation group had no deaths，the total effective rate was 93.3%.Conclusion：Severe neonatal pneumonia can cause multi system diseases and disorders，causing irreparable loss of children，and take the conventional treatment combined with small dose of Dopamine and Dobutamine on severe neonatal pneumonia treatment，can significantly improve childrens infection，promote the recovery of the system，so as to achieve better clinical effect，suitable for extensive promotion and application in clinic.

【Key words】 Severe neonatal infectious pneumonia； Dopamine； Dobutamine； Conventional therapyendprint

First-authors address：Fuzhou Second Hospital Affiliated to Xiamen University，Fuzhou 350007，China

肺炎是指終末氣道、肺泡和肺間質的炎癥，也是兒童時期需要重點防治的“四病”之一，同時肺炎也是發展中國家5歲以內兒童疾病死亡原因之首。按照病情肺炎可將其分為輕癥肺炎及重癥肺炎。新生兒感染性肺炎是新生兒常見疾病，可發生在產前、產時或產后，可由細菌、病毒或原蟲等病原體引起，是新生兒死亡的重要原因之一。產前感染常發生在孕母受感染之后，常見的病原體為巨細胞病毒、弓形蟲、大腸埃希菌、金黃色葡萄球菌、克雷白菌、李斯特菌和支原體等。產時感染發生在分娩過程中，胎兒吸了母親產道內細菌污染的分泌物所致，常見病原體為大腸桿菌、肺炎球菌、克雷白菌、李斯特菌和B族鏈球菌等?！?br>