發(fā)布時(shí)間：2018-02-13 15:12

  本文關(guān)鍵詞： 嬰兒 早產(chǎn) 呼吸暫停 咖啡因 治療結(jié)果　出處：《中國(guó)全科醫(yī)學(xué)》2017年10期 　論文類型：期刊論文

【摘要】：目的評(píng)估不同劑量咖啡因治療早產(chǎn)兒原發(fā)性呼吸暫停的臨床療效。方法選取2014年1月—2016年3月蕪湖市第一人民醫(yī)院新生兒科收治的原發(fā)性呼吸暫停早產(chǎn)兒48例,根據(jù)隨機(jī)數(shù)字表法分為低劑量組和高劑量組,每組24例。若呼吸暫停發(fā)作≥3次/d則應(yīng)用枸櫞酸咖啡因(意大利凱西制藥公司,生產(chǎn)批號(hào):13512)治療,低劑量組首劑量20 mg/kg,24 h后維持量為5 mg/kg,1次/d靜脈注射;高劑量組首劑量20 mg/kg,24 h后維持量為10mg/kg,1次/d靜脈注射,兩組均在呼吸暫停消失后平均(7±3)d停藥。比較兩組治療效果(包括治療有效率、撤機(jī)成功率及用藥期間機(jī)械通氣時(shí)間、氧暴露時(shí)間)、臨床結(jié)局(包括院內(nèi)死亡、支氣管肺發(fā)育不良、住院時(shí)間、神經(jīng)系統(tǒng)發(fā)育異常)及不良反應(yīng)(心動(dòng)過速、喂養(yǎng)不耐受、便秘、貧血、腹脹、電解質(zhì)紊亂)發(fā)生率。結(jié)果兩組性別、胎齡、體質(zhì)量、分娩方式、咖啡因開始時(shí)間、咖啡因維持時(shí)間、基礎(chǔ)呼吸支持間差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。高劑量組治療有效率、撤機(jī)成功率均高于低劑量組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);而兩組機(jī)械通氣時(shí)間、氧暴露時(shí)間間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組院內(nèi)死亡率、支氣管肺發(fā)育不良發(fā)生率、住院時(shí)間、神經(jīng)系統(tǒng)發(fā)育異常率間差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組心動(dòng)過速、喂養(yǎng)不耐受、便秘、貧血、腹脹、電解質(zhì)紊亂發(fā)生率間差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論枸櫞酸咖啡因每日維持量10 mg/kg較每日維持量5 mg/kg更能提高早產(chǎn)兒原發(fā)性呼吸暫停的療效和撤機(jī)成功率,同時(shí)也不會(huì)增加不良反應(yīng)的發(fā)生,值得在臨床推廣。
[Abstract]:Objective to evaluate the clinical efficacy of different doses of caffeine in treating premature infants with primary apnea. Methods 48 cases of premature infants with primary apnea were selected from January 2014 to March 2016 in Department of Neonatrics, first people's Hospital of Wuhu City. According to the random digital table method, they were divided into low dose group and high dose group with 24 cases in each group. If the apnea occurred more than 3 times a day, they were treated with caffeine citrate (Kathy Pharmaceutical Company, Italy, batch number: 13512). The first dose of 20 mg / kg in the low dose group was 5 mg / kg / d after 24 h, while in the high dose group it was 10 mg / kg / d at 24 h after the first dose of 20 mg / kg / kg. The effect of treatment (including the effective rate of treatment, the success rate of weaning, the time of mechanical ventilation, the time of oxygen exposure and the clinical outcome including hospital death) were compared between the two groups after the disappearance of apnea. The incidence of bronchopulmonary dysplasia, hospital stay, abnormal development of nervous system and adverse reactions (tachycardia, feeding intolerance, constipation, anemia, abdominal distension, electrolyte disturbance). There was no significant difference in the delivery mode, the onset time of caffeine, the duration of caffeine maintenance, and the basic respiratory support. The effective rate of treatment in the high dose group was higher than that in the low dose group, and the success rate of weaning was higher in the high dose group than in the low dose group. There was no significant difference in mechanical ventilation time and oxygen exposure time between the two groups (P 0.05). Hospital mortality, incidence of bronchopulmonary dysplasia, and hospitalization time were significantly different between the two groups. There was no significant difference in the rate of abnormal development of nervous system between the two groups (P 0.05). The two groups had tachycardia, feeding intolerance, constipation, anemia, abdominal distension, There was no significant difference in the incidence of electrolyte disturbance between the two groups (P 0.05). Conclusion 10 mg/kg of caffeine citrate per day is more effective than 5 mg/kg of daily maintenance of caffeine citrate in the treatment of primary apnea and the success rate of weaning in premature infants. At the same time also does not increase the occurrence of adverse reactions, worth in clinical promotion.
【作者單位】： 安徽省蕪湖市第一人民醫(yī)院新生兒科;
【分類號(hào)】：R722.6

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本文編號(hào)：1508456