不同无创通气联合枸橼酸咖啡因治疗早产儿呼吸暂停疗效分析  

Application of Different Noninvasive Ventilation Modes Combined with Caffeine Citrate in the Treatment of Apnea of Prematurity.

作　　者：林硕 罗厚江[1] 杨军 贾文婷[1] 汪灵芝[1] 沈怀云[1] LIN Shuo;LUO Houjiang;YANG Jun(The Second Affiliated Hospital of Bengbu Medical College,Anhui 233000,China)

机构地区：[1]蚌埠医学院第二附属医院新生儿科,233000

出　　处：《医学研究杂志》2024年第1期147-150,4,共5页Journal of Medical Research

基　　金：蚌埠医学院自然科学类重点项目(BYKY2019158ZD)。

摘　　要：目的通过分析不同无创辅助通气模式联合枸橼酸咖啡因在早产儿呼吸暂停中的治疗效果,探讨治疗早产儿呼吸暂停的优化方案。方法选择2019年10月~2022年8月蚌埠医学院第二附属医院新生儿重症监护病房收治的90例胎龄≤34周的呼吸暂停患儿作为研究对象,回顾性分析患儿的病例资料,将患儿分为NCPAP联合枸橼酸咖啡因组(n=44)和NIPPV序贯NCPAP联合枸橼酸咖啡因组(n=46)。采用t检验、χ2检验、Mann-Whitney检验等,对两组患儿一般临床资料、呼吸暂停疗效、治疗时间及不良反应发生情况,进行统计学比较。结果NIPPV序贯NCPAP联合枸橼酸咖啡因组治疗早产儿呼吸暂停总有效率为91.30%,高于NCPAP联合枸橼酸咖啡因组的86.36%,差异有统计学意义(P<0.05);两组无创通气失败及相关治疗时间比较,差异有统计学意义(P<0.05);两组在喂养不耐受、鼻损伤发生情况比较,差异有统计学意义(P<0.05)。结论早期采用NIPPV序贯NCPAP的通气模式,较传统单用NCPAP治疗早产儿呼吸暂停,可以取得更好的临床效果,缩短治疗及住院时间,不良反应相对更少,值得临床推广。Objective To explore the optimal protocol for treating apnea of prematurity by analyzing the effectiveness of different noninvasive assisted ventilation modes combined with caffeine citrate in preterm infants.Methods From October 2019 to August 2022,a total of 90 infants with apnea of prematurity(gestational age≤34 weeks)were chosen as research objects in the Neonatal Intensive Care Unit of the Second Affiliated Hospital of Bengbu Medical College,and the relevant data were retrospectively analyzed.The children were divided into nasal continuous positive airway pressure(NCPAP)combined with caffeine citrate group(44 cases),and noninvasive intermittent positive pressure ventilation(NIPPV)sequential NCPAP combined with caffeine citrate group(46 cases)according to the different treatment protocols adopted in the clinical treatment process.The general clinical data,apnea efficacy,treatment time,and occurrence of adverse effects between the two groups of prematurity were compared statistically by t-test,χ2 test,and Mann-Whitney rank sum test.Results The total efficiency of the NIPPV sequential NCPAP combined with caffeine citrate group in treating apnea of prematurity was 91.30%,higher than 86.36%in NCPAP combined with caffeine citrate group,and the difference was statistically significant(P<0.05).Statistically significant differences in failure of non-invasive ventilation and associated treatment time between the two groups(P<0.05)were observed.The difference between the two groups in the incidence of feeding intolerance and nasal injury was statistically significant(all P<0.05).Conclusion Early adoption of NIPPV sequential NCPAP ventilation mode can achieve better clinical results,shorten treatment and hospitalization time,and have relatively fewer adverse effects than traditional NCPAP alone in treating apnea of prematurity,which is worthy of clinical promotion.

关 键 词：早产儿 早产儿呼吸暂停 枸橼酸咖啡因 经鼻持续气道正压通气 经鼻间歇正压通气 

分 类 号：R722[医药卫生—儿科]