不同疗程枸橼酸咖啡因治疗早产儿呼吸暂停的疗效对比研究  

The Comparative Study on the Efficacy of Caffeine Citrate Therapy in Different Courses for Apnea of Prematurity

作　　者：谢若欣[1] 娄文飞 梁玉梅[1] XIE Ruoxin;LOU Wenfei;LIANG Yumei(Department of Pediatrics,Zhuhai Maternal and Child Health Hospital,Zhuhai,Guangdong Province,519000China)

机构地区：[1]珠海市妇幼保健院儿科,广东珠海519000

出　　处：《中外医疗》2021年第26期85-87,99,共4页China & Foreign Medical Treatment

摘　　要：目的观察不同疗程时间应用枸橼酸咖啡因防治早产儿原发性呼吸暂停的临床效果和安全性。方法随机选取2018年1月—2019年6月该院收治的孕周27~34周的早产儿60例为研究对象,根据枸橼酸咖啡因的使用时间来划分,疗程>14 d的患儿为长疗程组,疗程≤14 d的患儿为短疗程组。比较两组患儿的临床疗效、不良反应及并发症情况。结果长疗程组呼吸暂停人均发生次数为(1.17±0.70)次、复苏囊应用次数(0.20±0.10)次、经皮血氧饱和度为(92.27±1.10)%,均优于短疗程组(2.43±1.19)次、(0.50±0.12)次、(89.30±1.02)%,差异有统计学意义(t=-4.999、-10.519、10.844,P<0.001)。长疗程组不良反应发生率63.33%、并发症发生率16.67%,与短疗程组56.67%、20.00%相比较,差异无统计学意义(χ^(2)=0.278、0.111,P>0.05)。结论早产儿出生后尽早开始使用枸橼酸咖啡因防治呼吸暂停,疗程维持14 d以上(该研究平均疗程为27 d),可降低呼吸暂停发生次数,降低复苏囊使用次数,提高患儿经皮血氧饱和度。长疗程使用枸橼酸咖啡因不增加心动过速、烦躁不安、喂养不耐受和电解质紊乱不良反应的发生率,亦不增加脑室内出血、早产儿视网膜病、支气管肺发育不良并发症的发生率。早期长疗程应用枸橼酸咖啡因防治早产儿原发性呼吸暂停疗效显著、安全性好,值得临床推广应用。Objective To observe the clinical efficacy and safety of caffeine citrate therapy in different courses for apnea of prematurity.Methods 60 preterm infants with gestational age of 27-34 weeks admitted to the hospital from January 2018 to June 2019 were randomly selected as the research subjects.According to the days of caffeine citrate use,the children with treatment course of longer than 14 d were classified as the long course group,and the children with treatment course of less than 14 d were classified as the short course group.The clinical efficacy,adverse reactions and complications of the two groups were compared.Results The frequency of apnea per capita in the long course group were(1.17±0.70)times,(0.20±0.10)times and(92.27±1.10)%,which were better than that in the short course group(2.43±1.19)times,(0.50±0.12)times and(89.30±1.02)%,the difference was statistically significant(t=-4.999,-10.519,10.844,P<0.001).The incidence of adverse reactions and complications in the long course group were 63.33%and 16.67%,respectively,compared with 56.67%and 20.00%in the short course group,the difference was not statistically significant(χ^(2)=0.278,0.011,P>0.05).Conclusion The use of caffeine citrate for apnea prevention and treatment in premature infants as soon as possible after birth can reduce the frequency of apnea,reduce the use of resuscitation capsules,and improve the percutaneous oxygen saturation of infants with over 14 d of treatment(the average treatment in this study was 27 d).Long-term use of caffeine citrate did not increase the incidence of tachycardia,dysphoria,feeding intolerance,or electrolyte disturbances.It did not increase the incidence of intraventricular hemorrhage,retinopathy of prematurity and bronchopulmonary dysplasia.Early and long course of application of caffeine citrate in the prevention and treatment of primary apnea in premature infants has significant efficacy and good safety,which is worthy of clinical application.

关 键 词：不同疗程 枸橼酸咖啡因 早产儿呼吸暂停 

分 类 号：R246.4[医药卫生—针灸推拿学]