丁可军,余明敏,韩金芬
DING Kejun,YU Mingmin,Han Jinfen

• 1:郎溪县人民医院儿科
• 2:新乡医学院第三附院儿科

摘要(Abstract)：

目的:探讨应用小剂量多巴胺及多巴酚丁胺在减轻新生儿窒息所致多脏器损伤中的作用。方法:192例新生儿窒息患儿随机分为对照组和治疗组;对照组给予呼吸道清理、吸氧、纠正酸中毒、维持电解质平衡及血糖在正常高值等治疗;治疗组在对照组治疗基础上早期加用小剂量多巴胺和多巴酚丁胺;比较2组新生儿窒息患儿缺氧缺血性脑病(HIE)及胃肠损害治疗的总有效率,比较治疗前后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心音、心率、血尿素氮(BUN)、血肌酐(SCr)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及乳酸脱氢酶(LDH)的变化。结果:治疗后,治疗组HIE和胃肠功能损害治疗的总有效率高于对照组,心音、心率恢复总有效率高于对照组,差异有统计学意义(P<0.05);治疗后2组患儿CK、CK-MB、BUN、SCr、ALT、AST及LDH都下降,治疗组下降程度大于对照组(P<0.01)。结论:早期小剂量使用多巴胺及多巴酚丁胺,可以有效的治疗新生儿窒息所致的大脑、肝、肾、胃肠等重要脏器的损害。
Objective: To study the curative effects of small dose of dopamine and dobutamine in treating multiple organ damage caused by neonatal asphyxia in early stage. Methods: A total of 192 neonatal asphyxia cases were randomly divided into treatment group( 100 cases) and control group( 92cases). Patients in control group were given treatment such as clearing the respiratory tract,oxygen inhalation,correct acidosis,maintaining electrolyte balance and blood sugar in normal high value. On the basis of the treatment in control group,patients in treatment group were given small dose of dopamine and dobutamine. The total efficiency rates of hypoxic ischemic encephalopathy( HIE) and gastrointestinal damage were compared between the two groups. The levels of creatine kinase( CK),creatine kinase isoenzyme( CK-MB),heart sound,heart rate,blood urea nitrogen( BUN),serum creatinine( SCr),alanine aminotransferase( ALT),aspartate aminotransferase( AST) and lactatedehydrogenase( LDH) were detected. Results: After treatment,the total efficiency rates of HIE and gastrointestinal dysfunction in treatment group were higher than those in control group,and heart sound,heart rates recovery rates were higher than those in control group,the difference was statistically significant( P <0. 05); After treatment,levels of CK,CK-MB,BUN,SCr,LDH,ALT and AST in the two groups declined,but the decrease degree in treatment group was greater than that of the control group( P <0.01). Conclusions: Using small dose of dopamine and dobutamine in early stage can effectively reduce brain,liver and kidney and gastrointestinal function damages caused by asphyxia.

关键词(KeyWords)： 窒息,新生儿;多巴胺;多巴酚丁胺;肝功能试验;肾功能试验
asphyxia,neonate;dopamine;dobutamine;liver function test;kidney function test

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 丁可军,余明敏,韩金芬
DING Kejun,YU Mingmin,Han Jinfen

DOI: 10.19367/j.cnki.1000-2707.2014.05.022

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