發(fā)布時(shí)間：2018-10-30 09:01

【摘要】：目的觀察高劑量枸櫞酸咖啡因防治早產(chǎn)極低出生體質(zhì)量兒呼吸暫停的效果及安全性。方法選擇早產(chǎn)極低出生體質(zhì)量兒156例,隨機(jī)分為A、B、C三組各52例,于生后24 h內(nèi)給予枸櫞酸咖啡因治療。A組先予負(fù)荷劑量20 mg/(kg·d),24 h后維持劑量5 mg/(kg·d);B組先予負(fù)荷劑量20 mg/(kg·d),24 h后再次給予負(fù)荷劑量20 mg/(kg·d),48 h后維持劑量5 mg/(kg·d);C組先予負(fù)荷劑量20 mg/(kg·d),24 h后維持劑量10 mg/(kg·d)。三組維持劑量使用至患兒出生后糾正胎齡34周為止。比較三組呼吸暫停程度、重復(fù)上機(jī)例數(shù)、支氣管肺發(fā)育不良例數(shù)、氧療時(shí)間,觀察給藥后心動(dòng)過速、喂養(yǎng)不耐受、高血糖等不良反應(yīng)的發(fā)生情況。結(jié)果 C組發(fā)生呼吸暫停例數(shù)、呼吸暫停消失天數(shù)及嚴(yán)重程度評分、重復(fù)上機(jī)例數(shù)、支氣管肺發(fā)育不良例數(shù)均少或輕于其他兩組(P均0.05)。三組治療過程中不良反應(yīng)發(fā)生率比較無統(tǒng)計(jì)學(xué)差異。結(jié)論早產(chǎn)極低出生體質(zhì)量兒應(yīng)用枸櫞酸咖啡因防治呼吸暫停時(shí),按照負(fù)荷劑量20 mg/(kg·d)、維持劑量10 mg/(kg·d)直至糾正胎齡34周的給藥方案能夠減少呼吸暫停的發(fā)生,臨床效果顯著,安全性更高。
[Abstract]:Objective to observe the efficacy and safety of high dose caffeine citrate in the prevention and treatment of apnea in very low birth weight preterm infants. Methods 156 premature infants with very low birth weight were randomly divided into three groups: group A (n = 52) and group C (n = 52). Caffeine citrate was administered within 24 hours after birth. Group A was given a loading dose of 20 mg/ (kg d),. Maintenance dose of 5 mg/ (kg d); after 24 hours Group B was given the loading dose of 20 mg/ (kg d), for 24 h and the maintenance dose for 5 mg/ (kg d); after 48 h after the loading dose of 20 mg/ (kg d),. Group C received first loading dose of 20 mg/ (kg d), for 24 h and maintenance dose of 10 mg/ (kg d). The three groups were treated with maintenance dose until 34 weeks after birth correction. The degree of apnea, the number of repeated cases, the number of cases of bronchopulmonary dysplasia, the time of oxygen therapy, the occurrence of adverse reactions such as tachycardia, feeding intolerance and hyperglycemia were observed. Results in group C, the number of apnea, the days of apnea disappearance, the severity of apnea, the number of repeated cases and the number of cases of bronchopulmonary dysplasia were lower or lighter than those of the other two groups (P 0.05). There was no significant difference in the incidence of adverse reactions among the three groups. Conclusion caffeine citrate is used to prevent and treat apnea in premature infants with very low birth weight at a load dose of 20 mg/ (kg d),. Maintenance dose of 10 mg/ (kg d) to correct gestational age of 34 weeks can reduce the incidence of apnea, the clinical effect is significant, and the safety is higher.
【作者單位】： 廣西壯族自治區(qū)婦幼保健院;
【基金】：廣西衛(wèi)計(jì)委自籌經(jīng)費(fèi)科研課題(Z2015235)
【分類號】：R722.6

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