枸橼酸咖啡因联合牛肺表面活性剂治疗极/超低出生体重新生儿呼吸窘迫综合征的临床疗效分析  

Clinical efficacy analysis of caffeine citrate combined with calf pulmonary surfactant in the treatment of neonatal respiratory distress syndrome in extremely/ultra low birth weight neonates

作　　者：陈珊珊 CHEN Shan-shan(Department of Pediatrics,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院儿科,221000

出　　处：《中国实用医药》2025年第2期102-105,共4页China Practical Medicine

摘　　要：目的分析枸橼酸咖啡因联合牛肺表面活性剂治疗极/超低出生体重新生儿呼吸窘迫综合征(NRDS)的临床效果。方法选取62例极/超低出生体重NRDS患儿,随机分为对照组(30例)及观察组(32例)。所有患儿入院后均给予常规治疗,对照组使用气管内滴入牛肺表面活性剂治疗,观察组在对照组基础上增加枸橼酸咖啡因治疗。比较两组临床疗效,血气分析指标[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氢离子浓度指数(pH)、氧合指数(OI)],呼吸机参数[吸气峰压(PIP)、呼气末正压(PEEP)、吸入氧浓度(FiO_(2))],治疗指标(机械通气时间、氧疗时间、住院时间)。结果观察组总有效率93.75%高于对照组的73.33%(P<0.05)。治疗后,两组PaCO_(2)低于治疗前,pH、PaO_(2)、OI高于治疗前,且观察组PaCO_(2)(44.83±4.24)mm Hg(1 mm Hg=0.133 kPa)低于对照组的(47.12±3.38)mm Hg,pH(7.37±0.06)、PaO_(2)(81.21±10.25)mm Hg、OI(298.51±37.15)mm Hg高于对照组的(7.30±0.09)、(72.43±9.38)mm Hg、(230.78±35.22)mm Hg(P<0.05)。治疗后,两组FiO_(2)、PIP、PEEP均低于治疗前,且观察组FiO_(2)(0.24±0.10)、PIP(16.28±2.54)cm H_(2)O(1 cm H_(2)O=0.098 kPa)、PEEP(5.25±0.48)cm H_(2)O均低于对照组的(0.31±0.12)、(18.53±2.42)cm H_(2)O、(5.90±0.73)cm H_(2)O(P<0.05)。观察组的机械通气时间(7.25±3.53)d、氧疗时间(16.72±4.22)d、住院时间(26.25±12.29)d均短于对照组的(9.63±3.75)、(19.60±4.38)、(32.80±12.47)d(P<0.05)。结论枸橼酸咖啡因联合牛肺表面活性剂治疗极/超低出生体重NRDS患儿的效果显著,可缩短机械通气时间、用氧时间及住院时间,改善血气分析指标,提高肺功能及治疗效果。Objective To analyze the clinical effect of caffeine citrate combined with calf pulmonary surfactant in the treatment of neonatal respiratory distress syndrome(NRDS)in extremely/ultra low birth weight neonates.Methods 62 cases of extremely/ultra low birth weight neonates with NRDS were randomly divided into a control group(30 cases)and an observation group(32 cases).After admission,all children were given conventional therapy.On this basis,the control group was treated with intratracheal instillation of calf pulmonary surfactant,while the observation group was treated with caffeine citrate on the basis of the control group.Both groups were compared in terms of clinical efficacy,blood gas analysis indexes[arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2)),pH,oxygenation index(OI)],ventilator parameters[peak inspiratory pressure(PIP),positive end expiratory pressure(PEEP),fraction of inspiration O_(2)(FiO_(2))],and treatment indicators(mechanical ventilation time,duration of oxygen therapy,hospital stay).Results The total effective rate of 93.75% in the observation group was higher than 73.33% in the control group(P<0.05).After treatment,PaCO_(2)in both groups was lower than that before treatment,and pH,PaO_(2)and OI were higher than those before treatment;PaCO_(2)of(44.83±4.24)mm Hg(1 mm Hg=0.133 kPa)in the observation group was lower than(47.12±3.38)mm Hg in the control group;the observation group had pH of(7.37±0.06),PaO_(2)of(81.21±10.25)mm Hg and OI of(298.51±37.15)mm Hg,which were higher than(7.30±0.09),(72.43±9.38)mm Hg and(230.78±35.22)mm Hg in the control group(P<0.05).After treatment,FiO_(2),PIP and PEEP in both groups were lower than those before treatment;the observation group had FiO_(2)of(0.24±0.10),PIP of(16.28±2.54)cm H_(2)O(1 cm H_(2)O=0.098 kPa)and PEEP of(5.25±0.48)cm H_(2)O,which were lower than(0.31±0.12),(18.53±2.42)cm H_(2)O and(5.90±0.73)cm H_(2)O in the control group(P<0.05).In the observation group,the mechanical ventilation tim

关 键 词：枸橼酸咖啡因 牛肺表面活性剂 极/超低出生体重儿 新生儿呼吸窘迫综合征 

分 类 号：R72[医药卫生—儿科]