枸橼酸咖啡因治疗早产儿原发性呼吸暂停的临床效果及安全性评估  

Efficacy and safety evaluation of caffeine citrate in the treatment of primary apnea in premature infants

作　　者：楼佳俊 楼燕芳[1] 金巧燕[1] 季坚卫[1] 楼瑞英 潘小萍 LOU Jia-jun;LOU Yan-fang;JIN Qiao-yan;JI Jian-wei;LOU Rui-ying;PAN Xiao-ping(Department of Neonatology,Yiwu Central Hospital,Yiwu,Zhejiang 322000,China)

机构地区：[1]义乌市中心医院新生儿科,浙江义乌322000

出　　处：《中国妇幼保健》2023年第17期3231-3234,共4页Maternal and Child Health Care of China

基　　金：浙江省义乌市科研计划项目(义科20-3-035)。

摘　　要：目的探讨枸橼酸咖啡因治疗早产儿原发性呼吸暂停的临床效果及安全性评估。方法选取2019年1月—2020年12月义乌市中心医院收治的原发性呼吸暂停早产儿60例随机分为对照组和观察组,每组各30例。对照组采用氨茶碱进行治疗,观察组采用枸橼酸咖啡因进行治疗,两组均治疗3 d,并随访至患儿原发性呼吸暂停痊愈或患儿死亡。统计两组治疗3 d后的疗效及治疗期间治疗情况、不良反应发生情况,比较两组治疗3 d后早期肺功能参数和随访期间临床结局。结果治疗3 d后,观察组总有效率显著高于对照组(P<0.05)。治疗期间,观察组呼吸暂停次数少于对照组(P<0.05),撤机成功率(70.00%)高于对照组(43.33%,P<0.05),机械通气时间、给氧治疗时间短于对照组(P<0.05)。治疗3 d后,观察组呼吸频率(RR)、每分钟通气量、呼气峰流速值(PEF)、潮气量(TV)、25%潮气量时呼气流速(TEF25)、50%潮气量时呼气流速(TEF50)及75%潮气量时呼气流速(TEF75)均高于对照组(P<0.05)。治疗期间,观察组消化紊乱、高血糖、心动过速、高血压疾病、喂养困难及电解质紊乱发生率(6.67%、6.67%、3.33%、3.33%、10.00%、10.00%)与对照组(10.00%、13.33%、6.67%、3.33%、10.00%、10.00%)比较,差异均无统计学意义(均P>0.05)。随访期间,观察组院内死亡、支气管肺发育不良及神经系统发育不良发生率(3.33%、6.67%、3.33%)与对照组(3.33%、13.33%、6.67%)比较,差异均无统计学意义(均P>0.05)。结论枸橼酸咖啡因可有效降低原发性呼吸暂停早产儿呼吸暂停次数,缩短治疗时间,改善早产儿肺功能,具有较好的治疗效果。Objective To evaluate the efficacy and safety of caffeine citrate in the treatment of primary apnea in premature infants.Methods A total of 60 cases of preterm infants with primary apnea admitted to our hospital from January 2019 to December 2020 were selected as the research subjects,and they were divided into the control group(30 cases)and the observation group(30 cases)by random number table method.The control group was treated with aminophylline,and the observation group was treated with caffeine citrate.Both groups were treated for 3 d and followed up until primary apnea was cured or the children died.The curative effect after 3 d of treatment,the treatment conditions and the incidence of adverse reactions during treatment in the two groups were counted,and the early pulmonary function parameters after 3 d of treatment and the clinical outcome during follow-up were compared between the two groups.Results After 3 days of treatment,the total effective rate of the observation group was 100.00%,which was significantly higher than that of the control group(86.67%,P<0.05).During treatment,the frequency of apnea in the observation group was lower than that in the control group(P<0.05),the rate of success of withdrawal(70.00%)was higher than that in the control group(43.33%,P<0.05),the duration of mechanical ventilation and oxygen treatment were shorter than that in the control group(P<0.05).After 3 d of treatment,the respiratory rate(RR),ventilation per minute,the peak expiratory flow(PEF),tidal volume(TV),the 25%tidal expiratory flow(TEF25),the 50%tidal expiratory flow(TEF50),the 75%tidal expiratory flow(TEF75)in observation group were higher than those in control group(P<0.05).During treatment,The incidence of tachycardia,feeding difficulties,hyperglycemia,hypertension,digestive disorders and electrolyte disorders in the observation group(3.33%,10.00%,6.67%,3.33%,6.67%,10.00%)compared with the control group(10.00%,13.33%,6.67%,3.33%,10.00%,10.00%)and there was no statistical significance(allP>0.05).During follow-

关 键 词：原发性呼吸暂停 早产儿 枸橼酸咖啡因 氨茶碱 疗效 安全性 

分 类 号：R722.6[医药卫生—儿科]