氨茶碱伍用纳洛酮治疗早产儿原发性呼吸暂停疗效观察(附46例临床报告)

The clinical observation on effect of aminophylline plus naloxone on premature infant with primary apnea

目的观察氨茶碱伍用纳洛酮治疗早产儿原发性呼吸暂停的临床疗效。方法将112例早产儿随机分为两组,对照组(66例)和观察组(46例),对照组及观察组均应用氨茶碱治疗呼吸暂停,观察组加用纳洛酮,首次按0.1mg/kg静脉侧入,继之以0.1mg/kg,以0.03～0.05mg/(kg·h)速度静脉泵入,连用3d。比较两组原发性呼吸暂停的时间和发生次数、心率、经皮血氧饱和度等的差异。结果两组呼吸暂停次数为(1.6±0.9)次/dvs(3.0±1.7)次/d及日均积分(1.7±1.3)分vs(3.6±2.4)分,观察组均明显减少,P<0.001和P<0.05;呼吸暂停的时间(18.6±3.5)svs(20.2±3.9)s,观察组明显缩短;SpO2(81.0±10.6)%vs(75.4±8.9)%及心率(91.2±12.6)次/minvs(84.6±14.3)次/min,观察组下降程度明显减轻(P<0.05)。治疗组总有效率明显优于对照组(χ2=8.47,P<0.01)。结论氨茶碱伍用纳洛酮治疗早产儿原发性呼吸暂停疗效显著。

Objective To explore the efficiency of aminophylline plus naloxone on treating primary apnea of premature infants. Methods 112 patients were randomly divided into two groups, observation group （46） and control group（66）, all cases received aminophylline treatment. On this base, observation group was added naloxone with an initial dose of 0.1 mg/kg, followed by 0.1 mg/kg with 0.03-0.05 mg/（kg·h） pumped constantly into intravenously for 3 days. The differences of duration, episodes, heart rate and SpO2 of primary apnea of premature between two groups were compared. Results The results showed that episode of apnea （ 1.6±0.9） /d vs（3.0±1.7）/d and scores per day of apnea（ 1.7±1.3） vs（3.6±2.4） was greatly reduced in ebservation group, P〈0.001 and P〈0.05 respectively. The duration of apnea （ 18.6±3.5 ）s vs （20.2±3.9）s was greatly reduced in observation group（P〈0.05）. The degree of SpO2 （81.0±10.6）% vs （75.4±8.9）% and heart rate （91.2±12.6）/rain vs（84.6±14.3）min was alleviated （P〈0.05）. The total effective rate of the observation group was obviously higher than that of control group（X^2=8.47, P〈0.01）. Conclusion Aminophylline plus naloxone in treating primary apnea of premature is effective.