论文部分内容阅读
目的:探讨不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停的疗效和安全性。方法:将2015年5月至2016年5月期间我院NICU收入住院,出生胎龄<34周的88例符合原发性呼吸暂停的早产儿随机分为2组,两组采用不同维持剂量枸橼酸咖啡因静脉滴注治疗,低剂量组(首剂量20mg/kg,之后每日维持量为5mg/kg)与高剂量组(首剂量20mg/kg,之后每日维持量为10mg/kg),每组44例,直至患儿呼吸暂停消失1周停药。比较两组患儿的治疗后呼吸暂停的发作频次、接受机械通气比例、机械通气天数及呼吸暂停消失时间。结果:高剂量组患儿呼吸暂停发作频次、接受机械通气比例均低于低剂量组,高剂量组机械通气天数及呼吸暂停消失时间均短于低剂量组,两组比较差异有统计学意义(P<0.05)。两组患儿咖啡因治疗有关的不良反应事件发生率差异均无统计学意义(P>0.05)。两组患儿的临床合并症,包括颅内出血、新生儿坏死性小肠结肠炎、早产儿支气管肺发育不良、早产儿视网膜病变的发病率差异均无统计学意义(P>0.05)。结论:枸橼酸咖啡因以20mg/kg负荷量后,10mg/kg维持量治疗新生儿呼吸暂停效果显著,且安全性好。
Objective: To investigate the efficacy and safety of different maintenance doses of citrate caffeine in the treatment of apnea in premature infants. Methods: From May 2015 to May 2016 in our hospital NICU income hospitalization, birth gestational age <34 weeks of 88 cases of primary apnea-preterm children were randomly divided into two groups, two groups with different maintenance doses of citrate Citrate caffeine intravenous infusion of low-dose group (the first dose of 20mg / kg, followed by a daily maintenance dose of 5mg / kg) and high-dose group (the first dose of 20mg / kg, followed by a daily maintenance dose of 10mg / kg) , 44 cases in each group, until the patient apnea disappeared for 1 week. The frequency of episodes of apnea after treatment was compared between the two groups, and the proportion of mechanical ventilation, days of mechanical ventilation, and disappearance of apnea were compared. Results: The frequency of episodes of apnea and the proportion of mechanical ventilation in high-dose group were lower than those in low-dose group. The days of mechanical ventilation and the disappearance of apnea in high-dose group were shorter than those in low-dose group. The difference was statistically significant P <0.05). There was no significant difference in the incidence of adverse reactions between two groups of children treated with caffeine (P> 0.05). There were no significant differences in the incidence of clinical complications between the two groups, including intracranial hemorrhage, neonatal necrotizing enterocolitis, bronchopulmonary dysplasia in preterm infants, and retinopathy of prematurity (P> 0.05). CONCLUSIONS: Citrate caffeine at 20mg / kg loading, 10mg / kg maintenance of neonatal apnea effect is significant, and good security.