咖啡因预防小胎龄早产儿呼吸暂停效果观察  

The efficacy of caffeine in the prevention of apnea in small gestational age of premature infants

作　　者：赵颖[1] 郑军[1] 田秀英[1] 张婉娴[1] ZHAO Ying;ZHENG Jun;TIAN Xiu-ying;ZHANG Wan-xian(Department of Neonatology, Tianjin Central Obstetrics and Gynecology Hospital, Tianjin 300100, China)

机构地区：[1]天津市中心妇产科医院新生儿科,300100

出　　处：《天津医药》2017年第5期518-521,共4页Tianjin Medical Journal

基　　金：天津市卫生局科技基金(2015kz076)

摘　　要：目的观察对小胎龄早产儿使用枸橼酸咖啡因预防呼吸暂停的临床效果、不良反应及预后,探讨咖啡因预防早产儿呼吸暂停的有效性及安全性。方法研究对象为2015年1月—2016年7月天津市中心妇产科医院新生儿科收治的小胎龄早产儿132例。随机分为咖啡因组及对照组。咖啡因组于生后满24 h即开始经静脉输入枸橼酸咖啡因,首剂20 mg/kg,24 h后开始给予维持量5 mg/kg,每日1次,直至矫正胎龄满34周。对照组不使用甲基黄嘌呤类药物。至咖啡因组用药48 h后对2组患儿的呼吸暂停发生率、使用呼吸机及经鼻持续呼吸道正压通气(n-CPAP)时长、喂养不耐受发生率、心动过速发生率、动脉导管未闭(PDA)发生率、颅内出血发生率、坏死性小肠结肠炎(NEC)发生率、支气管肺发育不良(BPD)发生率、体质量增长速率及住院时间进行比较。结果咖啡因组用药48 h后呼吸暂停发生率、住院期间使用呼吸机及n-CPAP时长、生后1周PDA发生率、颅内出血发生率、住院时间等均低于对照组(P<0.05);而2组喂养不耐受、心动过速、NEC、BPD等发生率及体质量增长速率差异均无统计学意义(P>0.05)。结论对小胎龄早产儿预防性给予咖啡因可有效减少原发性呼吸暂停的发生,改善早产儿预后,且无明显不良反应发生。Objective To explore the therapeutic effect and security of caffeine citrate in preventing primary apnea ofpreterm infants by observing the clinical effect,adverse reaction and prognosis of caffeine citrate preventing the primaryapnea.Methods A total of132preterm infants admitted to neonatal department of Tianjin Central Hospital of Obstetricsand Gynecology were selected during January2015to July2016.They were randomly divided into two groups,one was thecaffeine group,and the other was the control group.The infants of caffenine group were intravenous injected caffeine citrate24hours after birth,with the first dose20mg/kg,and the maintain dose5mg/kg every24hours,until the correctedgestational age was34weeks.The infants of control group were not given methylxanthine drugs.Data were comparedbetween two groups including the incidence of apena after48hours of giving drugs,the period of using nasal continuouspositive airway pressure(n-CPAP)or ventilator,the incidence of feeding intolerance,tachycardia,patent ductus arteriosus(PDA),intracranial hemorrhage(HIE),necrotizing enterocolitis(NEC),and bronchopulmonary dysplasia(BPD),weightgrowth rate and the length of hospitalization.Results There were significantly lower incidence of apnea after48hours,theperiod of using nasal continuous positive airway pressure or ventilator,incidence of patent ductus arteriosus and intracranialhemorrhage and the duration of hospitalization in caffeine group than those in control group(P<0.05).There were nostatistically significant differences in the incidence of feeding intolerence,bradycardia,NEC,BPD and the weight growthrate between the two groups(P>0.05).Conclusion The preterm infants given caffeine could reduce the incidence of theprimary apnea,improve the prognosis of the preterm infants,and no significant adverse reaction.

关 键 词：婴儿 早产 婴儿 早产 疾病 呼吸暂停 预后 咖啡因 原发性呼吸暂停 

分 类 号：R722.6[医药卫生—儿科]