咖啡因治疗早产儿呼吸暂停的临床效果及预后分析

Analysis on Clinical Effect and Prognosis of Caffeine in the Treatment of Apnea in Premature Infants

目的:探讨枸橼酸咖啡因治疗早产儿呼吸暂停的临床疗效及对患儿预后的影响。方法:根据入院先后顺序将2014年3月—2017年2月我院收治的68例呼吸暂停早产儿分为两组,各34例,对照组应用氨茶碱[初始负荷量5 mg/kg,静滴,30 min内滴完,12 h后调整为维持剂量:2 mg/kg与10 mL葡萄糖注射液(10%)混合后静滴,q12 h]治疗,观察组应用枸橼酸咖啡因(初始负荷量20 mg/kg,静滴,30 min内滴完,12 h后调整为维持剂量:5 mg/kg,静滴,qd)治疗,比较两组疗效及不良反应发生情况。结果:与用药前比较,两组治疗后血氧分压(PaO_2)值显著升高,二氧化碳分压(PaCO_2)值显著降低,差异有统计学意义(P <0.05);两组治疗总有效率比较,差异无统计学意义(P> 0.05);观察组腹胀、心率加快、胃潴留、支气管肺发育不良(BPD)、喂养不耐受发生率均显著低于对照组,差异有统计学意义(P <0.05)。结论:枸橼酸咖啡因治疗早产儿呼吸暂停的疗效确切,且安全性好。

Objective:To investigate the clinical efficacy of caffeine citrate in the treatment of apnea in premature infants and its effect on the prognosis of the infants.Methods:According to the order of admission,68 premature infants with apnea admitted to our hospital from March 2014 to February 2017 were divided into two groups,34 cases each.The infants in the control group were treated with aminophylline[initial load:5 mg/kg,intravenous drip within 30 min,12 h later,the dose was adjusted to maintenance dose:2 mg/kg,intravenous drip after the drug was mixed with 10 mL glucose injection(10%),q12 h],and the infants in the observation group were treated with caffeine citrate(initial load:20 mg/kg,intravenous drip within 30 min,12 h later,the dose was adjusted to maintenance dose:5 mg/kg,intravenous drip,qd).The efficacy and adverse reactions were compared between the two groups.Results:Compared with those before treatment,the value of blood oxygen partial pressure(PaO2)after treatment in the two groups was significantly increased,and the value of carbon dioxide partial pressure(PaCO2)was significantly decreased,with statistically significant differences(P<0.05).There was no statistically significant difference in the total effective rate between the two groups(P<0.05).The incidences of abdominal distention,heart rate acceleration,gastric retention,bronchopulmonary dysplasia(BPD)and feeding intolerance in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:Caffeine citrate is effective and safe in the treatment of apnea in premature infants.