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小儿肺炎合并心衰是儿科最常见的危重症之一。近年来,镁在心衰时的改变以及与心衰发生的关系已受到临床医师的重视。镁具有扩张血管、改善心肌代谢、加强心肌收缩力、减少氧耗、利尿保钾和止痉镇静等作用。由于洋地黄和利尿剂的应用,尿镁排出增加,加之缺氧和进食量减少等因素,均可造成体内缺镁,致使心衰难于纠正,而引起顽固性心衰。我科于1989年1月至1989年8月期间对小儿重症肺炎合并反复性心衰的28例患儿,在常规应用洋地黄及抗生素后收效不佳的情况下,加用25%硫酸镁治疗。实践证明:加镁后效果良好,且无副作用。我们并在同一期间将21例不加镁治疗的患儿作疗效对照。现将疗效观察及护理介绍如下。
Pediatric pneumonia complicated with heart failure is one of the most common critically ill pediatric diseases. In recent years, changes in magnesium in heart failure and the relationship with heart failure has been the clinician’s attention. Magnesium has dilated blood vessels, improve myocardial metabolism, strengthen myocardial contractility, reduce oxygen consumption, diuretic potassium and antispasmodic sedation and so on. Due to digitalis and diuretic applications, increased urinary magnesium excretion, combined with hypoxia and reduced intake of other factors, can cause magnesium deficiency in the body, resulting in difficult to correct heart failure, which led to refractory heart failure. In our department from January 1989 to August 1989 period of severe pneumonia in children with recurrent heart failure in 28 cases of children with routine use of digitalis and antibiotics ineffective circumstances, plus 25% magnesium sulfate treatment . Practice has proved that: after the magnesium effect is good, and no side effects. In the same period, we also treated 21 children who did not receive magnesium therapy. The efficacy of observation and nursing are as follows.