不同时间应用咖啡因预防极超低出生体重儿呼吸暂停的临床研究

Efficacy of caffeine for prevention apnea in very and extremely low birth weight infants at different starting time

目的探讨不同时间应用咖啡因预防极超低出生体重儿呼吸暂停的临床效果。方法以2016年1月至2017年11月收治的胎龄25~32周早产儿42例为研究对象,根据应用枸橼酸咖啡因的时间分为生后24小时内给药组、生后24小时至3天给药组。比较两组患儿的临床疗效及并发症发生情况。结果生后24小时至3天给药组呼吸暂停发生率、气管插管率、氧疗天数、用药天数均低于生后24小时内给药组,差异有显著性(χ~2=4.601,P=0.033;χ~2=5.490,P=0.019;t=2.939,P=0.005;t=2.300,P=0.027)。两组脑室内出血、坏死性小肠结肠炎、早产儿视网膜病、支气管肺发育不良的发生率比较,差异无显著性(P>0.05)。结论生后24小时至3天预防性应用枸橼酸咖啡因可能降低极超低出生体重儿呼吸暂停、气管插管发生率,减少氧疗天数及用药天数。

Objective To investigate the efficacy of caffeine prevention and treatment apnea in very and extremely low birth weight infants at different starting time. Method Totally 42 very and extremely low birth weight infants during January 2016 to November 2017 were analyzed. According to the time of caffeine citrate, the patients were divided into treatment group within 24 hours after birth and 24 hours to 3 day after birth. The clinical efficacy and complications of the two groups were compared. Result Compared with treatment group at 24 hours to 3 day after birth, the incidence of apnea and tracheal intubation, duration of oxygen therapy and intervention duration of caffeine citrate in the treatment group within 24 hours after birth were decreased（χ^2=4.601, P=0.033; χ^2=5.490, P=0.019; t=2.939, P=0.005; t=2.300, P=0.027）. The incidence of IVH, NEC, ROP and BPD were no significantly different in the two groups（P〉0.05）.Conclusion The preventive use of caffeine citrate at 24 hours to 3 days after birth may reduce the incidence of apnea, tracheal intubation, and reduce duration of oxygen therapy and intervention duration of caffeine citrate.