不同剂量咖啡因治疗早产儿原发性呼吸暂停的临床疗效研究  

Clinical Effects of Different Dosage of Caffeine Therapy for Premature Infants with Primary Apnea

作　　者：范莉莉[1] 王婷[1] 王佐[1] 

机构地区：[1]安徽省芜湖市第一人民医院新生儿科,241000

出　　处：《中国全科医学》2017年第10期1204-1207,共4页Chinese General Practice

摘　　要：目的评估不同剂量咖啡因治疗早产儿原发性呼吸暂停的临床疗效。方法选取2014年1月—2016年3月芜湖市第一人民医院新生儿科收治的原发性呼吸暂停早产儿48例,根据随机数字表法分为低剂量组和高剂量组,每组24例。若呼吸暂停发作≥3次/d则应用枸橼酸咖啡因(意大利凯西制药公司,生产批号:13512)治疗,低剂量组首剂量20 mg/kg,24 h后维持量为5 mg/kg,1次/d静脉注射;高剂量组首剂量20 mg/kg,24 h后维持量为10mg/kg,1次/d静脉注射,两组均在呼吸暂停消失后平均(7±3)d停药。比较两组治疗效果(包括治疗有效率、撤机成功率及用药期间机械通气时间、氧暴露时间)、临床结局(包括院内死亡、支气管肺发育不良、住院时间、神经系统发育异常)及不良反应(心动过速、喂养不耐受、便秘、贫血、腹胀、电解质紊乱)发生率。结果两组性别、胎龄、体质量、分娩方式、咖啡因开始时间、咖啡因维持时间、基础呼吸支持间差异均无统计学意义(P>0.05)。高剂量组治疗有效率、撤机成功率均高于低剂量组,差异有统计学意义(P<0.05);而两组机械通气时间、氧暴露时间间差异无统计学意义(P>0.05)。两组院内死亡率、支气管肺发育不良发生率、住院时间、神经系统发育异常率间差异均无统计学意义(P>0.05)。两组心动过速、喂养不耐受、便秘、贫血、腹胀、电解质紊乱发生率间差异均无统计学意义(P>0.05)。结论枸橼酸咖啡因每日维持量10 mg/kg较每日维持量5 mg/kg更能提高早产儿原发性呼吸暂停的疗效和撤机成功率,同时也不会增加不良反应的发生,值得在临床推广。Objective To evaluate the clinical effects of different dosage of caffeine therapy for premature infants with primary apnea. Methods Forty - eight premature infants with primary apnea admittd in Wuhu No. 1 People′s Hospital from January 2014 to March 2016 were selected and divided into low - dose group （n = 24）and high - dose group （n = 24）according to the random number table method. The subjects were treated with caffeine citrate （Chiesi Farmaceutici,batch Number：13512） if apnea occurs 3 times or more a day. The low - dose group took a dose of 20 mg/ kg for the first time,maintenance dose of 5 mg/kg after 24 hours,and received intravenous injection once a day;while the high - dose group took a dose of 20 mg/ kg for the first time,maintenance dose of 10 mg/ kg after 24 hours,and received intravenous injection once a day. Both groups were discontinued drugs （7 ± 3）days after the disappearance of apnea. The treatment effects （including treatment efficiency,success rate of withdrawing respirator and the mechanical ventilation time,oxygen exposure duration during medication）,clinical outcomes （including hospital death,bronchopulmonary dysplasia,hospital stay,neurological dysplasia）and occurrence of adverse reactions （tachycardia,feeding intolerance,constipation,anemia,abdominal distension,electrolyte imbalance）of patients in the two groups were compared. Results There were no significant differences in gender,gestational age,body weight,mode of delivery,initiation time of caffeine,maintenance time of caffeine and basic respiratory support between the two groups （P 〉 0. 05）. The effective rate of treatment and success rate of withdrawing respirator in the high - dose group weresignificantly higher than those in the low - dose group （P 〈 0. 05）,while mechanical ventilation time and oxygen exposure duration were not significantly different between the two groups （P 〉 0. 05）. There was no significant difference in the hospital death,incidence of bronchopulmonary dysplasi

关 键 词：婴儿 早产 呼吸暂停 咖啡因 治疗结果 

分 类 号：R725.6[医药卫生—儿科]