枸橼酸咖啡因联合呼吸机辅助呼吸对新生儿呼吸窘迫综合征的有效性及安全性研究

The Efficacy and Safety of Caffeine Citrate Combined with Ventilator Assisted Respiration on Neonatal Respiratory Distress Syndrome

目的:探讨枸橼酸咖啡因联合呼吸机辅助呼吸对新生儿呼吸窘迫综合征(NRDS)的有效性及安全性。方法:选取我院2015年8月—2017年8月收治的N R D S患儿106例为研究对象,随机分为对照组和治疗组各53例。对照组患儿给予呼吸机辅助呼吸治疗,治疗组患儿给予呼吸机辅助呼吸联合枸橼酸咖啡因治疗,比较两组患儿临床疗效以及合并症发生情况。结果:治疗前,两组患儿Pa CO2、Pa O2、Fi O2以及OI水平比较差异无统计学意义(P>0.05);与治疗前比较,治疗后1h、6h、24h以及48h两组患儿Pa CO2、Fi O2以及OI水平均明显下降,Pa O2明显上升,且治疗组治疗后各时间段Pa CO2、Fi O2以及OI水平明显低于对照组,Pa O2明显高于对照组,差异显著(P<0.05);治疗组患儿氧疗时间、呼吸机使用时间以及开奶时间分别为(101.02±27.43)h、(76.93±27.56)h和(62.81±19.60)h,均明显低于对照组的(119.62±37.68)h、(84.21±23.79)h和(79.53±19.11)h,差异显著(P<0.05);治疗组患儿合并症发生率为13.21%,对照组合并症发生率为16.98%,两组比较差异无统计学意义(P>0.05)。结论:枸橼酸咖啡因联合呼吸机辅助呼吸治疗新生儿呼吸窘迫综合征疗效显著,能改善患儿氧合指数及氧分压水平,缩短机械通气时间,且临床应用安全性较高。

Objective： To investigate the ef？cacy and safety of caffeine citrate combined with ventilator assisted respiration on NRDS. Methods： 106 cases of NRDS in our hospital from August 2015 to August 2017 were selected as the subjects, and randomly divided into the control group and the treatment group （53 cases each）. The children in the control group were given respirator assisted breathing therapy, and the treatment group received breathing machine assisted respiration combined with citric acid caffeine treatment. The clinical ef？cacy and complications of the two groups were compared. Results： Before treatment, the two groups had no statistical signi？cance in PaCO2, PaO2, FiO2 and OI level （P〉0.05）; and after treatment, during 1h, 6h, 24h, 48h, FiO2, PaCO2 and OI of two groups were signi？cantly decreased, PaO2 increased signi？cantly; and after treatment during each time PaCO2 FiO2 and OI levels were signi？cantly lower, and PaO2 was signi？cantly higher in the treatment group compared with the control group（P〈0.05）; oxygen therapy, mechanical ventilation time and open milk time in the treatment group was （101.02＋27.43） h, （76.93＋27.56） h, and （62.81＋19.60） h, respectively, which were signi？cantly lower than that of the control group （119.62＋37.68） h, （84.21＋23.79） h, and （79.53＋19.11） h, （P〈0.05）; the incidence of complications in treatment group was 13.21%, in control group was 16.98%, two groups had no difference Meaning （P〉0.05）. Conclusion： Caffeine citrate combined with respirator assisted breathing is effective in the treatment of neonatal respiratory distress syndrome. It can improve the level of oxygenation index and oxygen partial pressure, shorten the time of mechanical ventilation, and has high safety in clinical application.