枸橼酸咖啡因与氨茶碱治疗新生儿呼吸窘迫综合征的疗效及安全性比较  

Comparison of the efficacy and safety of caffeine citrate and aminophylline in the treatment of neonatal respiratory distress syndrome

作　　者：刘燕好 廖世雄[2] 谢燕媚 LIU Yanhao;LIAO Shixiong;XIE Yanmei(The First Maternal and Child Health Hospital of Huizhou,Huizhou 516001,China;Huizhou Central People’s Hospital,Huizhou 516001)

机构地区：[1]惠州市第一妇幼保健院,广东惠州516001 [2]惠州市中心人民医院,广东惠州516001

出　　处：《现代医院》2022年第6期959-961,965,共4页Modern Hospitals

基　　金：广东省中医药局面上科研基金项目(20191325)。

摘　　要：目的探讨枸橼酸咖啡因注射液与氨茶碱注射液治疗新生儿呼吸窘迫综合征的临床疗效及安全性。方法选择2020年1月—2021年12月收治的452例新生儿呼吸窘迫综合征为研究对象。按随机数字表法分为咖啡因组227例与氨茶碱组225例。咖啡因组:采用枸橼酸咖啡因注射液,首剂20 mg/kg静脉注射,24 h后每日给予维持量(5 mg/kg),1次/d;氨茶碱组:采用氨茶碱注射液首剂5 mg/kg静脉注射,维持剂量按标准剂量2.5 mg/kg,1次/12 h,密切监测7 d呼吸暂停情况,无呼吸暂停则停药。监测期间详细记录两组药物治疗情况,比较给药前后患儿呼吸暂停发生次数、持续时间、首次拔管成功率及停药后再次辅助通气率;比较每分钟肺通气量、潮气量、吸呼比、呼吸频率、呼气流量峰值(PEF)、达峰时间的改善情况,统计不良反应发生率。结果咖啡因组患儿机械通气时间天数、吸氧时间、插管时间、住院时间、每天发生呼吸暂停次数均短于氨茶碱组;每分钟肺通气量、吸呼比、潮气量、呼气流量峰值(PEF)、达峰时间均高于氨茶碱组,差异有统计学意义(P<0.05)。比较两组患儿首次拔管成功率及再次辅助通气率,差异无统计学意义(P>0.05)。咖啡因组发生低血钾、多尿及喂养不耐受低于氨茶碱组,差异有统计学意义(P<0.05)。结论枸橼酸咖啡因注射液治疗新生儿呼吸窘迫综合征的疗效及安全性均高于氨茶碱注射液。Objective To explore the clinical efficacy and safety of caffeine citrate injection and aminophylline injection in the treatment of neonatal respiratory distress syndrome.Methods 452 cases of neonatal respiratory distress syndrome who were admitted from January 2020 to December 2021 were selected as the research objects.According to the random number table method,they were divided into 227 cases of caffeine group and 225 cases of aminophylline group.Caffeine group:caffeine citrate injection,the first dose of 20 mg/kg intravenously,24 hours later,the maintenance dose(5 mg/kg)was given once a day;aminophylline group:amino tea,the first dose of alkali injection was 5 mg/kg intravenously,and the maintenance dose was 2.5 mg/kg at the standard dose,once every 12 hours.The apnea situation was closely monitored for 7 days,and the drug was discontinued if there was no apnea.During the monitoring period,the drug treatment conditions of the two groups were recorded in detail,and the number of occurrences of apnea,the duration,the success rate of first extubation and the rate of re-assisted ventilation after drug withdrawal were compared before and after drug administration.ratio,respiratory rate,peak expiratory flow(PEF),time to peak,and the incidence of adverse reactions.Results In terms of curative effect,the days of mechanical ventilation,oxygen inhalation time,intubation time,hospitalization time,and the number of daily apnea in the caffeine group were shorter than those in the aminophylline group;The volume,peak expiratory flow(PEF),and peak time were higher than those in the aminophylline group,and the difference was statistically significant(P<0.05).There was no significant difference in the success rate of first extubation and the rate of re-assisted ventilation between the two groups(P>0.05).In terms of safety,the occurrence of hypokalemia,polyuria and feeding intolerance in the caffeine group was lower than that in the aminophylline group,and the differences were statistically significant(P<0.05).Conclusion The ef

关 键 词：新生儿呼吸窘迫综合征 枸橼酸咖啡因注射液 氨茶碱注射液 

分 类 号：R722.12[医药卫生—儿科]