高剂量与低剂量咖啡因治疗早产儿原发性呼吸暂停效果及安全性研究

发布时间：2019-07-21 10:14

【摘要】：目的探讨高剂量与低剂量咖啡因治疗早产儿原发性呼吸暂停的临床效果和安全性。方法选择2014年8月—2016年8月洛阳市妇女儿童医疗保健中心收治的早产儿原发性呼吸暂停患儿104例,采用随机数字表法分为对照组和观察组,每组52例。观察组给予枸橼酸咖啡因首次剂量为20 mg/kg,静脉滴注时间在30 min以上,24 h后维持15 mg/kg,1次/d,在呼吸暂停消失7 d后停药。对照组给予枸橼酸咖啡因首次剂量为20 mg/kg,静脉滴注时间在30 min以上,24 h后维持5 mg/kg,1次/d,在呼吸暂停消失7 d后停药。观察并记录两组患儿治疗效果,治疗第1天、第2天、第3天记录呼吸暂停发生次数及呼吸暂停严重程度评分,用药后可能发生的不良反应,两组呼吸机使用次数及使用时间。结果观察组治疗效果优于对照组,差异有统计学意义(u=-2.717,P=0.007)。观察组治疗第1天、第2天、第3天呼吸暂停发生次数少于对照组,呼吸暂停严重程度评分低于对照组(P0.05)。两组患儿心动过速、烦躁不安、喂养困难、高血糖症、低钾血症、总不良反应发生率比较,差异均无统计学意义(P0.05)。观察组患儿呼吸机使用率低于对照组,呼吸机使用时间短于对照组(χ~2=10.636,P0.05;t=2.232,P0.05)。结论高剂量咖啡因治疗早产儿原发性呼吸暂停疗效优于低剂量,可减轻患儿临床症状,减少呼吸暂停发生次数,降低呼吸机使用率,值得临床推广。
[Abstract]:Objective to investigate the clinical effect and safety of high dose and low dose caffeine in the treatment of primary dyspnea in premature infants. Methods from August 2014 to August 2016, 104 premature infants with primary dyspnea were randomly divided into control group (n = 52) and observation group (n = 52). In the observation group, caffeine citrate was given intravenously for more than 30 min at the first dose of 20 mg/kg, maintained for 15 mg/kg,1 / d 24 hours later, and stopped after 7 days of apnea. The control group was given caffeine citrate for the first time at a dose of 20 mg/kg, for more than 30 min, maintained for 5 mg/kg,1 / d 24 hours later, and stopped taking caffeine for 7 days after Apnea disappeared. The therapeutic effect of the two groups was observed and recorded. On the first, second and third day of treatment, the frequency of Apnea and the score of severity of Apnea, the possible adverse reactions after treatment, the times and time of ventilator use in the two groups were recorded. Results the therapeutic effect of the observation group was better than that of the control group, and the difference was statistically significant (u 鈮，

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