纳洛酮联合氨茶碱治疗早产儿原发性呼吸暂停疗效观察

Clinical therapeutic effect of naloxone associated with aminophylline On primary apnea of premature Infant

目的:现察纳洛酮联合氨茶碱治疗早产儿原发性呼吸暂停的疗效。方法:选择自2002年1月至2007年1月在本院新生儿病房住院的早产儿68例,随机分为治疗组和对照组各34例,两组病例在首次发生呼吸暂停之后,均给予氨茶碱负荷量5 mg/kg于20 min内静脉滴注,12 h后给2.5 mg/kg的维持量,每隔12 h静脉滴注或灌肠一次。治疗组同时加用纳洛酮,首次0.1 mg/kg静脉注射,继而按0.1 mg/kg加入10%萄萄糖注射液20 mL以0.02～0.04 mg/(kg·h)静脉泵入。结果:治疗组显效率70.6%,总有效率95.1%,对照组显效率47.2%,总有效率73.7%,显效率比较x^2=3.98,P<0.05,总有效率比较x^2=6.71,P<0.01.差异均具有统计学意义。结论:纳洛酮联合氨茶碱治疗早产儿原发性呼吸暂停比单用氨茶碱疗效好,并对减少早产儿的后遗症有着重要意义。

Objective：To research the clinical therapeutic effect of naloxone associated with aminophylline on primary apnea of premature infant. Methods： From January 2002 to January 2007, 74 premature infants suffering from primary apnea in our hospital were divided into two groups. One was treatment group （34 cases） and the other was control group （34 cases）. All the members of the two groups were given intravenously 5 mg/kg of first dose of aminophylline and the 2 mg/kg maintenance, dose of aminophylline 12 hours later. Aminophylline was given to patients regularly once per 12 hours, The members in the treatment group were given naloxone in addition to aminophylline. The first dose of naloxone was 0.1 mg/kg and then naloxone was dropped into patients at 0.02 -0.04 mg·kg^-1·h^-1. Results： In the treatment group, the effectual rate and total effective rate were 70.6% and 95.1% respectively. At the same time, the effectual rate and total effective rate in the control group were 47.2% and 73.7% respectively. The effectual ratio of treatment group was higher than that of control group and so was the total effective rate, there is a significant difference between the control group and the treatment group in effectual ratio （χ^2 = 3. 98, P 〈 0. 05） and a highly significant difference between the two groups in total effective ratio （χ^2 = 6. 71, P 〈 0.01 ）. Conclusions： CLinical therapeutic effect on primary apnea of premature infants with aminophylline and naloxone is more effective than with aminophylline alone.