加温湿化高流量鼻导管通气联合枸橼酸咖啡因治疗早产儿呼吸暂停的效果观察

Effect of Humidified High-Flow Nasal Cannula Combined with Caffeine Citrate in the Treatment of Apnea of Prematurity

目的探究加温湿化高流量鼻导管通气(HHFNC)联合枸橼酸咖啡因对早产儿呼吸暂停(AOP)的影响。方法选取2020年6月—2023年6月滕州中心人民医院收治的76例AOP患儿为研究对象,按随机数字表法将其分为对照组和观察组,各38例。对照组行枸橼酸咖啡因联合经鼻持续气道正压通气(NCPAP),观察组行枸橼酸咖啡因联合HHFNC。对比两组的临床疗效、症状改善情况、血气分析指标、并发症发生情况。结果治疗后,观察组治疗总有效率为94.74%,高于对照组的78.95%,呼吸暂停时间为(15.24±1.69)s/次,住院时间为(18.50±2.57)d,均短于对照组的(19.71±2.56)s/次、(24.43±3.96)d,呼吸暂停发作次数为(1.34±0.23)次/d,少于对照组的(2.26±0.37)次/d,并发症发生率为7.89%,低于对照组的26.32%,氧分压为(72.93±8.20)mmHg(1 mmHg=0.133 kPa),高于对照组的(65.85±6.34)mmHg,二氧化碳分压为(40.18±2.88)mmHg,低于对照组的(45.30±3.96)mmHg,组间差异有统计学意义(P<0.05)。结论HHFNC联合枸橼酸咖啡因能够减轻AOP患儿的症状,调节血气分析指标,且不会增加并发症,值得临床推广与应用。

Objective Exploring the effect of humidified high-flow nasal cannula(HHFNC)combined with caffeine citrate on apnea of prematurity(AOP).Methods A total of 76 children with AOP admitted to Tengzhou Central People's Hospital from June 2020 to June 2023 were selected as the research subjects,and were divided into a control group and an observation group using a random number table method,with 38 cases in each group.The control group received caffeine citrate combined with nasal continuous positive airway pressure(NCPAP),while the observation group received caffeine citrate combined with HHFNC.The clinical efficacy,symptom improvement,blood gas analysis indicators,and complications between the two groups were compared.Results After treatment,the total effective rate of the observation group was 94.74%,which was higher than the control group's 78.95%,the respiratory pause time was(15.24±1.69)s/time,and the hospital stay was(18.50±2.57)days,which was shorter than the control group's(19.71±2.56)s/time and(24.43±3.96)days,the incidence of apnea was(1.34±0.23)times/day,which was lower than the control group's(2.26±0.37)times/day,the incidence of complications was 7.89%,lower than the control group's 26.32%,the PaO2 was(72.93±8.20)mmHg(1 mmHg=0.133 kPa),which was higher than the control group's(65.85±6.34)mmHg,the PaCO2 was(40.18±2.88)mmHg,and lower than the control group's(45.30±3.96)mmHg,the differences between the groups were statistically significant(P<0.05).Conclusion HHFNC combined with caffeine citrate can alleviate symptoms in children with AOP,regulate blood gas analysis indicators,and do not increase complications.It is worthy of clinical promotion and application.