不同剂量咖啡因治疗早产儿原发性呼吸暂停的临床疗效研究

发布时间：2018-02-13 15:12

本文关键词： 婴儿早产呼吸暂停咖啡因治疗结果　出处：《中国全科医学》2017年10期 　论文类型：期刊论文

【摘要】：目的评估不同剂量咖啡因治疗早产儿原发性呼吸暂停的临床疗效。方法选取2014年1月—2016年3月芜湖市第一人民医院新生儿科收治的原发性呼吸暂停早产儿48例,根据随机数字表法分为低剂量组和高剂量组,每组24例。若呼吸暂停发作≥3次/d则应用枸橼酸咖啡因(意大利凯西制药公司,生产批号:13512)治疗,低剂量组首剂量20 mg/kg,24 h后维持量为5 mg/kg,1次/d静脉注射;高剂量组首剂量20 mg/kg,24 h后维持量为10mg/kg,1次/d静脉注射,两组均在呼吸暂停消失后平均(7±3)d停药。比较两组治疗效果(包括治疗有效率、撤机成功率及用药期间机械通气时间、氧暴露时间)、临床结局(包括院内死亡、支气管肺发育不良、住院时间、神经系统发育异常)及不良反应(心动过速、喂养不耐受、便秘、贫血、腹胀、电解质紊乱)发生率。结果两组性别、胎龄、体质量、分娩方式、咖啡因开始时间、咖啡因维持时间、基础呼吸支持间差异均无统计学意义(P0.05)。高剂量组治疗有效率、撤机成功率均高于低剂量组,差异有统计学意义(P0.05);而两组机械通气时间、氧暴露时间间差异无统计学意义(P0.05)。两组院内死亡率、支气管肺发育不良发生率、住院时间、神经系统发育异常率间差异均无统计学意义(P0.05)。两组心动过速、喂养不耐受、便秘、贫血、腹胀、电解质紊乱发生率间差异均无统计学意义(P0.05)。结论枸橼酸咖啡因每日维持量10 mg/kg较每日维持量5 mg/kg更能提高早产儿原发性呼吸暂停的疗效和撤机成功率,同时也不会增加不良反应的发生,值得在临床推广。
[Abstract]:Objective to evaluate the clinical efficacy of different doses of caffeine in treating premature infants with primary apnea. Methods 48 cases of premature infants with primary apnea were selected from January 2014 to March 2016 in Department of Neonatrics, first people's Hospital of Wuhu City. According to the random digital table method, they were divided into low dose group and high dose group with 24 cases in each group. If the apnea occurred more than 3 times a day, they were treated with caffeine citrate (Kathy Pharmaceutical Company, Italy, batch number: 13512). The first dose of 20 mg / kg in the low dose group was 5 mg / kg / d after 24 h, while in the high dose group it was 10 mg / kg / d at 24 h after the first dose of 20 mg / kg / kg. The effect of treatment (including the effective rate of treatment, the success rate of weaning, the time of mechanical ventilation, the time of oxygen exposure and the clinical outcome including hospital death) were compared between the two groups after the disappearance of apnea. The incidence of bronchopulmonary dysplasia, hospital stay, abnormal development of nervous system and adverse reactions (tachycardia, feeding intolerance, constipation, anemia, abdominal distension, electrolyte disturbance). There was no significant difference in the delivery mode, the onset time of caffeine, the duration of caffeine maintenance, and the basic respiratory support. The effective rate of treatment in the high dose group was higher than that in the low dose group, and the success rate of weaning was higher in the high dose group than in the low dose group. There was no significant difference in mechanical ventilation time and oxygen exposure time between the two groups (P 0.05). Hospital mortality, incidence of bronchopulmonary dysplasia, and hospitalization time were significantly different between the two groups. There was no significant difference in the rate of abnormal development of nervous system between the two groups (P 0.05). The two groups had tachycardia, feeding intolerance, constipation, anemia, abdominal distension, There was no significant difference in the incidence of electrolyte disturbance between the two groups (P 0.05). Conclusion 10 mg/kg of caffeine citrate per day is more effective than 5 mg/kg of daily maintenance of caffeine citrate in the treatment of primary apnea and the success rate of weaning in premature infants. At the same time also does not increase the occurrence of adverse reactions, worth in clinical promotion.
【作者单位】：安徽省芜湖市第一人民医院新生儿科;
【分类号】：R722.6

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