不同维持剂量枸橼酸咖啡因治疗新生儿呼吸暂停的临床效果

Clinical effect of different maintenance doses of caffeine citrate in the treatment of neonatal apnea

目的分析不同维持剂量枸橼酸咖啡因治疗新生儿呼吸暂停的临床效果。方法选取2017年1月至2021年4月我院收治的60例新生儿呼吸暂停患儿作为研究对象,根据枸橼酸咖啡因维持剂量将其分为低剂量组(5 mg/kg)与高剂量组(10 mg/kg),各30例。比较两组的临床疗效、呼吸暂停发作频率及严重程度评分、不良反应发生情况、血气指标、呼吸机相关参数、置管时长及拔管后再次出现呼吸暂停时间。结果高剂量组的治疗总有效率高于低剂量组(P<0.05)。用药第3、7天,高剂量组的呼吸暂停发作频率及严重程度评分低于低剂量组(P<0.05)。两组的心动过速、喂养不耐受、血压升高、便秘、低钾血症发生率比较,差异无统计学意义(P>0.05)。用药72 h后,高剂量组的PaCO_(2)、最高气道峰压、最高氧浓度低于低剂量组,PaO_(2)高于低剂量组(P<0.05)。高剂量组的置管时长短于低剂量组,拔管后再次出现呼吸暂停时间长于低剂量组(P<0.05)。结论10 mg/kg枸橼酸咖啡因用于新生儿呼吸暂停治疗中可取得理想效果。

Objective To analyze the clinical effect of different maintenance doses of caffeine citrate in the treatment of neonatal apnea.Methods A total of 60 children with neonatal apnea treated in our hospital from January 2017 to April 2021 were selected as the research objects.According to the maintenance dose of caffeine citrate,the children were divided into low-dose group(5 mg/kg)and high-dose group(10 mg/kg),with 30 cases in each group.The clinical efficacy,attack frequency and severity score of apnea,occurrence of adverse reactions,blood gas indexes,ventilator related parameters,catheterization time and the time of reoccurrence of apnea after extubation were compared between the two groups.Results The total effective rate of treatment in the high-dose group was higher than that in the low-dose group(P<0.05).At 3rd and 7th days of medication,the attack frequency and severity score of apnea in the high-dose group were lower than those in the low-dose group(P<0.05).There were no significant differences in the incidences of tachycardia,feeding intolerance,elevated blood pressure,constipation and hypokalemia between the two groups(P>0.05).At 72 h after medication,the PaCO_(2),the highest peak airway pressure and the highest oxygen concentration in the high-dose group were lower than those in the low-dose group,and the PaO_(2) was higher than that in the low-dose group(P<0.05).The catheterization time in the high-dose group was shorter than that in the low-dose group,and the time of reoccurrence of apnea after extubation was longer than that in the low-dose group(P<0.05).Conclusion The 10 mg/kg caffeine citrate can achieve ideal effect in the treatment of neonatal apnea.