枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停的临床研究

Clinical study of caffeine citrate and aminophylline in the treatment of apnea of prematurity

目的:研究枸橼酸咖啡因和氨茶碱治疗早产儿呼吸暂停的临床疗效。方法:选择早产儿病房收治的呼吸暂停的早产儿65例,患儿在常规治疗(保持正确的体位、按摩脊背、弹足底)不能缓解时加用药物治疗,枸橼酸咖啡因组35例给予枸橼酸咖啡因治疗,氨茶碱组30例给予氨茶碱治疗,比较2组患儿的无创机械通气时间、有创机械通气时间、吸氧时间及早产儿并发症发生率。结果:枸橼酸咖啡因组患儿的无创机械通气时间、有创机械通气时间、吸氧时间均明显短于氨茶碱组(P <0. 01),支气肺发育不良发生率亦低于氨茶碱组(P <0. 05); 2组患儿早产儿视网膜病、脑室内出血、脑白质软化及新生儿坏死性小肠结肠炎的发生率差异均无统计学意义(P> 0. 05)。结论:枸橼酸咖啡因可减少呼吸暂停早产儿的无创机械通气时间、有创机械通气时间、吸氧时间和支气肺发育不良的发生率。

Objective： To explore the clinical effects of caffeine citrate and aminophylline in the treatment of apnea in of prematurity.Methods： Sixty-five premature infants with apnea from March 2014 to August 2015 were treated with conventional method（ including keeping the correct position,massaging back and playing a foot） combined with drug. Thirty-five cases were treated with caffeine citrate（ caffeine citrate group）,and 30 cases were treated with aminophylline（ aminophylline group）. The time of non-invasive mechanical ventilation,time of invasive mechanical ventilation,oxygen time and incidence rate of complication between two groups were compared.Results： The time of non-invasive mechanical ventilation,time of invasive mechanical ventilation and oxygen time in caffeine citrate group were shorter than those in aminophylline group（ P〈0. 01）,and the incidence rate of bronchial dysplasia in caffeine citrate group was lower than that in aminophylline group（ P〈0. 05）. The differences of the incidence rates of retinopathy,intraventricular hemorrhage,leukomalacia and necrotizing enterocolitis of newborn between two groups were not statistically significant（ P〉0. 05）.Conclusions： Caffeine citrate can reduce the time of non-invasive mechanical ventilation,invasive mechanical ventilation time,oxygen time and incidence rate of bronchial dysplasia in premature infant with apnea.