高剂量枸橼酸咖啡因维持疗法防治早产极低出生体质量儿呼吸暂停效果观察

发布时间：2018-10-30 09:01

【摘要】：目的观察高剂量枸橼酸咖啡因防治早产极低出生体质量儿呼吸暂停的效果及安全性。方法选择早产极低出生体质量儿156例,随机分为A、B、C三组各52例,于生后24 h内给予枸橼酸咖啡因治疗。A组先予负荷剂量20 mg/(kg·d),24 h后维持剂量5 mg/(kg·d);B组先予负荷剂量20 mg/(kg·d),24 h后再次给予负荷剂量20 mg/(kg·d),48 h后维持剂量5 mg/(kg·d);C组先予负荷剂量20 mg/(kg·d),24 h后维持剂量10 mg/(kg·d)。三组维持剂量使用至患儿出生后纠正胎龄34周为止。比较三组呼吸暂停程度、重复上机例数、支气管肺发育不良例数、氧疗时间,观察给药后心动过速、喂养不耐受、高血糖等不良反应的发生情况。结果 C组发生呼吸暂停例数、呼吸暂停消失天数及严重程度评分、重复上机例数、支气管肺发育不良例数均少或轻于其他两组(P均0.05)。三组治疗过程中不良反应发生率比较无统计学差异。结论早产极低出生体质量儿应用枸橼酸咖啡因防治呼吸暂停时,按照负荷剂量20 mg/(kg·d)、维持剂量10 mg/(kg·d)直至纠正胎龄34周的给药方案能够减少呼吸暂停的发生,临床效果显著,安全性更高。
[Abstract]:Objective to observe the efficacy and safety of high dose caffeine citrate in the prevention and treatment of apnea in very low birth weight preterm infants. Methods 156 premature infants with very low birth weight were randomly divided into three groups: group A (n = 52) and group C (n = 52). Caffeine citrate was administered within 24 hours after birth. Group A was given a loading dose of 20 mg/ (kg d),. Maintenance dose of 5 mg/ (kg d); after 24 hours Group B was given the loading dose of 20 mg/ (kg d), for 24 h and the maintenance dose for 5 mg/ (kg d); after 48 h after the loading dose of 20 mg/ (kg d),. Group C received first loading dose of 20 mg/ (kg d), for 24 h and maintenance dose of 10 mg/ (kg d). The three groups were treated with maintenance dose until 34 weeks after birth correction. The degree of apnea, the number of repeated cases, the number of cases of bronchopulmonary dysplasia, the time of oxygen therapy, the occurrence of adverse reactions such as tachycardia, feeding intolerance and hyperglycemia were observed. Results in group C, the number of apnea, the days of apnea disappearance, the severity of apnea, the number of repeated cases and the number of cases of bronchopulmonary dysplasia were lower or lighter than those of the other two groups (P 0.05). There was no significant difference in the incidence of adverse reactions among the three groups. Conclusion caffeine citrate is used to prevent and treat apnea in premature infants with very low birth weight at a load dose of 20 mg/ (kg d),. Maintenance dose of 10 mg/ (kg d) to correct gestational age of 34 weeks can reduce the incidence of apnea, the clinical effect is significant, and the safety is higher.
【作者单位】：广西壮族自治区妇幼保健院;
【基金】：广西卫计委自筹经费科研课题(Z2015235)
【分类号】：R722.6

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