枸橼酸咖啡因剂量差异对呼吸暂停早产儿拔管失败率、并发症及不良反应的影响

Effect of caffeine citrate dose difference on extubation failure rate,complications,and adverse reactions of premature infants with apnea

目的探讨枸橼酸咖啡因剂量差异对呼吸暂停早产儿拔管失败率、并发症及不良反应的影响,为临床提供参考。方法选择2014年1月-2016年12月首都儿科研究所附属儿童医院收治的100例原发性呼吸暂停早产儿为研究对象,以随机数字表法分为A组(50例)和B组(50例),分别给予常规剂量和大剂量枸橼酸咖啡因辅助治疗;比较两组患儿拔管失败率、呼吸暂停发生、呼吸暂停持续时间、机械通气时间、氧疗时间、住院时间、并发症发生率、死亡率及不良反应发生率等。结果B组患儿拔管失败率和呼吸暂停发生次数较显著低于A组(均P<0.05);B组患儿呼吸暂停持续时间、机械通气时间、氧疗时间及住院时间均显著短于A组(均P<0.05);两组患儿NEC、BPD、ROP、IVH及PVL发生率比较差异无统计学意义(P>0.05);两组患儿死亡率比较,差异无统计学意义(P>0.05);两组患儿心动过速和高血压发生率比较,差异无统计学意义(P>0.05)。结论大剂量枸橼酸咖啡因用于呼吸暂停早产儿可有效降低拔管失败率和发作次数,缩短治疗所需时间,且未增加并发症和不良反应风险。

Objective To explore the effect of caffeine citrate dose difference on extubation failure rate, complications, and adverse reactions of premature infants with apnea, provide a reference for clinical treatment. Methods From January 2014 to December 2016, 100 premature infants with primary apnea were selected from Children＇s Hospital, Capital Institute of Pediatrics, then they were divided into A group （caffeine citrate of conventional dose） and B group （caffeine citrate of large dose） according to random number table, 50 premature infants in each group. The failure rates of extubation, the incidence rates and duration time of apnea, mechanical ventilation time, oxygen therapy time, hospitalization time, incidence rates of complications, mortality rates, and incidence rates of adverse reactions in the two groups were compared. Results The failure rate of extubation and times of apnea in B group were statistically significantly lower than those in A group （P〈0. 05） . The duration time of apnea, mechanical ventilation time, oxygen therapy time, and hospitalization time in B group were statistically significantly shorter than those in A group （ P〈0. 05 ） . There was no statistically significant difference in the incidence rates of NEC, BPD, ROP, IVH, and PVL between the two groups （P〉0. 05） . There was no statistically significant difference in mortality rate between the two groups （P〉0. 05 ） . There was no statistically significant difference in the incidence rates of tachycardia and hypertension between the two groups （P〉0. 05 ）. Conclusion Large-dose caffeine citrate can efficiently reduce the failure rate of extubation and the attacks number, shorten the time required for treatment in treatment of preterm infants with apnea, and the therapy can not increase complications and adverse reactions.