咖啡因联合PS、无创呼吸机在早产儿RDS中的应用效果  

Application effect of caffeine combined with pulmonary surfactant and non-invasive ventilator for treating premature infants with respiratory distress syndrome

作　　者：刘瑞 张莹 LIU Rui;ZHANG Ying(The First Affiliated Hospital of Air Force Military Medical University,Xi'an,Shanxi Province,710000)

机构地区：[1]空军军医大学第一附属医院,西安710000

出　　处：《中国计划生育学杂志》2024年第12期2923-2928,共6页Chinese Journal of Family Planning

摘　　要：目的:分析枸橼酸咖啡因联合肺表面活性物质(PS)、经鼻持续气道正压通气(nCPAP)治疗呼吸窘迫综合征(RDS)早产儿效果。方法:回顾性分析本院2021年7月-2023年7月收治的RDS早产儿临床资料,从接受PS联合nCPAP治疗的患儿中选取45例纳入常规组,枸橼酸咖啡因联合PS、nCPAP治疗的患儿中选取40例纳入咖啡因组。比较两组住院时间、用氧时间、呼吸暂停次数及并发症发生情况,分析血气指标及血清相关炎性因子水平变化;比较两组治疗3d时临床疗效。结果:经治疗,咖啡因组住院时间(23.12±2.03d)、总用氧时间(80.14±20.58h)、呼吸暂停数(4.02±0.58次)均低于常规组(25.07±2.69d、106.43±32.61h、7.14±1.03次),两组pH、PaO_(2)水平上升且咖啡因组(7.35±0.10、69.54±9.02mmHg)均高于常规组(7.20±0.05、60.37±8.14mmHg),两组PaCO_(2)水平及血清相关炎性因子指标下降且PaCO_(2)咖啡因组(40.16±5.63mmHg)低于常规组(43.08±6.31mmHg)(均P<0.05);治疗3d时,咖啡因组治疗总有效率(87.5%)高于常规组(68.9%),治疗期间支气管发育不良发生率(5.0%)低于常规组(22.2%)(均P<0.05)。结论:nCPAP治疗RDS患儿采用枸橼酸咖啡因联合PS干预可有效缩短24h呼吸暂停次数及给氧时间,改善血气指标和机体炎症反应,降低BPD发生率,促进患儿康复。Objective:To analyze the application effect of caffeine citrate combined with pulmonary surfactant(PS)and non-invasive ventilator for treating premature infants with respiratory distress syndrome(RDS).Methods:The clinical data of the premature infants with RDS admitted to the hospital between July 2021 and July 2023 were analyzed retrospectively.45 infants who had received the treatment of PS combined with nasal continuous positive airway pressure(nCPAP)were included in the study group,and 40 infants who had received the treatment of the caffeine citrate combined with PS and nCPAP were selected in the study group.The duration of the hospital stay,the oxygen therapy time,the apnea frequency and the complications occurrence of the infants were compared between the two groups.The changes of the blood gas indicators and the serum inflammatory factors of the infants in the two groups were analyzed.The clinical efficacy of the infants after 3 days of treatment was compared between the two groups.Results:After treatment,the hospitalization time(23.12±2.03d),the total oxygen used time(80.14±20.58h)and the apnea number(4.02±0.58 times)of the infants in the study group were significantly lower than those(25.07±2.69d,106.43±32.61 h and 7.14±1.03 times)of the infants in the control group.The pH value and PaO_(2) level of the infants in the two groups after treatment had increased significantly,and which(7.35±0.10 and 69.54±9.02 mmHg)of the infants in the study group were significantly higher than those(7.20±0.05 and 60.37±8.14 mmHg)of the infants in the control group.The PaCO_(2) value and the serum inflammatory factors levels of the infants in the two groups after treatment had decreased significantly,and the PaCO_(2) value(240.16±5.63 mmHg)of the infants in the study group was significantly lower than that(43.08±6.31 mmHg)of the infants in the control group(all P<0.05).After 3 days of treatment,the total effective rate(87.5%)of the infants in the study group was significantly higher than that(68.9%)of the infan

关 键 词：早产儿 呼吸窘迫综合征 肺表面活性物质 枸橼酸咖啡因 临床疗效 并发症 

分 类 号：R722.6[医药卫生—儿科]