经鼻间歇正压通气联合枸橼酸咖啡因治疗早产儿呼吸暂停的临床疗效

Clinical efficacy of nasal intermittent positive pressure ventilation combined with caffeine citrate in children with apnea of prematurity

目的探究经鼻间歇正压通气(NIPPV)联合枸橼酸咖啡因治疗早产儿呼吸暂停(AOP)的临床疗效。方法选取2019年1月至2020年12月本院新生儿重症监护室(NICU)收治的128例AOP患儿作为研究对象,按照随机数字表法分为对照组与观察组,每组64例。对照组给予常规治疗和枸橼酸咖啡因治疗,观察组在对照组基础上给予NIPPV治疗,比较两组临床疗效、呼吸暂停消失时间、住院时间、不良反应发生率及并发症发生率。结果观察组治疗总有效率为93.75%,高于对照组的81.25%,差异有统计学意义(P<0.05)。观察组呼吸暂停消失时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为12.50%,略低于对照组的17.19%,但组间比较差异无统计学意义。观察组支气管肺发育不良、颅内出血、新生儿坏死性小肠结肠炎发生率分别为14.06%、0.00%、6.25%,均低于对照组的29.69%、9.38%、20.31%,差异有统计学意义(P<0.05)。结论NIPPV联合枸橼酸咖啡因治疗AOP疗效确切,可促进患儿疾病好转,减少不良反应及支气管肺发育不良等严重并发症的发生,值得临床推广应用。

Objective To investigate the clinical efficacy of nasal intermittent positive pressure ventilation(NIPPV)combined with caffeine ci-trate in the treatment of children with apnea of prematurity(AOP).Methods 128 children with AOP admitted to the neonatal intensive care unit(NI-CU)of our hospital from January 2019 to December 2020 were selected as the research subjects,and they were divided into the control group and the observation group according to the random number table method,with 64 cases in each group.The control group were treated with routine therapy and caffeine citrate,the observation group were treated with NIPPV on the basis of the control group,the clinical efficacy,apnea disappearance time,hospitalization time,incidence of adverse reactions and incidence of complications were compared between the two groups.Results The total effec-tive rate of the observation group was 93.75%,which was higher than 81.25%of the control group,and the difference was statistically significant(P<0.05).The apnea disappearance time and hospitalization time of the observation group were shorter than those in the control group,and the differenc-es were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 12.50%,which was slightly lower than 17.19%in the control group,but there was no significant difference between the two groups.The incidence of bronchopulmonary dysplasia,intracra-nial hemorrhage and neonatal necrotizing enterocolitis in the observation group were 14.06%,0.00%,6.25%,respectively,which were lower than 29.69%,9.38%,and 20.31%in the control groups,and the differences were statistically significant(P<0.05).Conclusion NIPPV combined with caffeine citrate is effective in the treatment of children with AOP,which can promote the improvement of the disease,reduce the incidence of adverse reactions and serious complications such as bronchopulmonary dysplasia,and it is worthy of clinical promotion and application.