枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停临床比较研究
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摘要
目的:比较枸橼酸咖啡因与氨茶碱对早产儿呼吸暂停的治疗效果及对血气指标的影响。方法:选取2016年3月至2017年12月我院收治的原发性呼吸暂停早产儿96例,随机分为枸橼酸咖啡因组和氨茶碱组各48例,分别给予相应药物治疗,比较两组患儿的临床疗效、发作次数、呼吸暂停消失时间、住院时间、血气指标及并发症的发生情况。结果:枸橼酸咖啡因组总有效率为93. 75%,高于氨茶碱组的70. 83%(P<0. 05)。治疗后,枸橼酸咖啡因组患儿呼吸暂停发作次数少于氨茶碱组;呼吸暂停消失时间、氧疗时间及住院时间均短于氨茶碱组(P均<0. 01);两组患儿的PaO_2、PaO_2/Fi O_2均升高,且枸橼酸咖啡因组高于氨茶碱组(P均<0. 05);两组患儿的PaCO_2均降低,且枸橼酸咖啡因组低于氨茶碱组(P均<0. 05)。枸橼酸咖啡因组患儿的并发症发生率低于氨茶碱组(P<0. 05)。结论:枸橼酸咖啡因治疗早产儿呼吸暂停的临床效果显著,能有效改善血气指标、减少不良反应,比氨茶碱更具优势。
Objective: To compare the effects of caffeine citrate and aminophylline on apnea in preterm infants and the effects on blood gas parameters. Methods: Totally 96 preterm infants with primary apnea admitted into our hospital from Mar. 2016 to Dec. 2017 were selected to be randomly divided into caffeine citrate group and aminophylline group,with 48 cases in each group. The caffeine citrate group and aminophylline group were given corresponding drug treatment,and the clinical efficacy,attack number of episodes,time of apnea disappearance,length of stay,blood gas index and complications were compared between two groups. Results: The total effective rate of caffeine citrate group was 93. 75%,higher than that of aminophylline group(70. 83%)( P<0. 05). After treatment,the attack number of apnea episodes in the citrate caffeine group was lower than that in the aminophylline group; the time of apnea disappearance,time of oxygen therapy and length of stay were shorter than those in the aminophylline group( P< 0. 01). The PaO_2,PaO_2/FiO_2 were increased in both groups,and the caffeine citrate group was higher than the aminophylline group( P<0. 05). The PaCO_2 was decreased in both groups,and the caffeine citrate group was lower than the aminophylline group( P<0. 05). The incidence of complications in the caffeine citrate group was lower than that in the aminophylline group( P < 0. 05). Conclusion: Caffeine citrate has a more significant clinical effect in the treatment of apnea in preterm infants,which can effectively improve the blood gas indexes and reduce the adverse drug reactions,and has an advantage over aminophylline.
Objective: To compare the effects of caffeine citrate and aminophylline on apnea in preterm infants and the effects on blood gas parameters. Methods: Totally 96 preterm infants with primary apnea admitted into our hospital from Mar. 2016 to Dec. 2017 were selected to be randomly divided into caffeine citrate group and aminophylline group,with 48 cases in each group. The caffeine citrate group and aminophylline group were given corresponding drug treatment,and the clinical efficacy,attack number of episodes,time of apnea disappearance,length of stay,blood gas index and complications were compared between two groups. Results: The total effective rate of caffeine citrate group was 93. 75%,higher than that of aminophylline group(70. 83%)( P<0. 05). After treatment,the attack number of apnea episodes in the citrate caffeine group was lower than that in the aminophylline group; the time of apnea disappearance,time of oxygen therapy and length of stay were shorter than those in the aminophylline group( P< 0. 01). The PaO_2,PaO_2/FiO_2 were increased in both groups,and the caffeine citrate group was higher than the aminophylline group( P<0. 05). The PaCO_2 was decreased in both groups,and the caffeine citrate group was lower than the aminophylline group( P<0. 05). The incidence of complications in the caffeine citrate group was lower than that in the aminophylline group( P < 0. 05). Conclusion: Caffeine citrate has a more significant clinical effect in the treatment of apnea in preterm infants,which can effectively improve the blood gas indexes and reduce the adverse drug reactions,and has an advantage over aminophylline.
引文
[1]刘枭,周彬,吴杰斌,等.枸橼酸咖啡因联合双水平正压通气治疗早产儿呼吸暂停疗效观察[J].儿科药学杂志,2017,23(11):14-17.
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[10]冯秀芳,王莉,常霞.不同剂量咖啡因用于早产儿呼吸暂停的临床效果比较[J].中国基层医药,2017,24(11):1689-1692.
[11]吴春艳,王晓娇,王媛媛.枸椽酸咖啡因对新生儿呼吸暂停血气指标的影响[J].海南医学院学报,2015,21(11):1539-1541.
[12]冯彬彬,曹蓓,王鷁超,等.血氨检测对早产儿胃肠外营养安全评估的临床研究[J].湖南师范大学学报(医学版),2015,12(3):32-34.
[13]向芬,易小青.不同胎龄新生儿呼吸窘迫综合征的临床特点比较及其疗效研究[J].湖南师范大学学报(医学版),2016,13(3):40-42.
[14]MOHR M A,FAIRCHILD K D,PATEL M,et al. Quantification of periodic breathing in premature infants[J]. Physiol Meas,2015,36(7):1415-1427.
[15]许景林,王瑞泉,陈冬梅.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的比较[J].中国当代儿科杂志,2014,16(11):1129-1132.
[16]张磊,高瑛,孙建伟,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停疗效分析[J].中华实用诊断与治疗杂志,2016,30(8):789-791.
[2]王玉,倪莎莎,韩丽华.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的临床对照研究[J].药物评价研究,2017,40(11):1622-1625.
[3]GIZZI C,MONTECCHIA F,PANETTA V,et al. Is synchronised NIPPV more effective than NIPPV and NCPAP in treating apnea of prematurity(AOP)? A randomised cross-over trial[J]. Arch Dis Child Fetal Neonatal Ed,2015,100(1):F17-F23.
[4]林万青,黄玉平,朱晓河,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的疗效比较[J].现代诊断与治疗,2015,26(5):1029-1030.
[5]鄢爱红,汪斌,郭笔君,等.枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停的安全性及疗效比较[J].当代医学,2017,23(19):115-117.
[6]邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].北京:人民卫生出版社,2011:245-247.
[7]何焱志,黄梅.枸橼酸咖啡因治疗极低出生体重早产儿呼吸暂停的临床研究[J].广西医科大学学报,2016,33(4):650-653.
[8]TEY S L,LEE W T,LEE P L,et al. Neurodevelopmental outcomes in very low birth weight infants using aminophyllinefor the treatment of apnea[J]. Pediatr Neonatol,2016,57(1):41-46.
[9]朱洪斌,高彩云,闫爱霞,等.枸橼酸咖啡因联合正压通气治疗呼吸暂停早产儿的疗效及对血清饥饿激素、胰岛素样生长因子结合蛋白3的影响[J].中国妇幼保健,2018,33(3):595-597.
[10]冯秀芳,王莉,常霞.不同剂量咖啡因用于早产儿呼吸暂停的临床效果比较[J].中国基层医药,2017,24(11):1689-1692.
[11]吴春艳,王晓娇,王媛媛.枸椽酸咖啡因对新生儿呼吸暂停血气指标的影响[J].海南医学院学报,2015,21(11):1539-1541.
[12]冯彬彬,曹蓓,王鷁超,等.血氨检测对早产儿胃肠外营养安全评估的临床研究[J].湖南师范大学学报(医学版),2015,12(3):32-34.
[13]向芬,易小青.不同胎龄新生儿呼吸窘迫综合征的临床特点比较及其疗效研究[J].湖南师范大学学报(医学版),2016,13(3):40-42.
[14]MOHR M A,FAIRCHILD K D,PATEL M,et al. Quantification of periodic breathing in premature infants[J]. Physiol Meas,2015,36(7):1415-1427.
[15]许景林,王瑞泉,陈冬梅.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的比较[J].中国当代儿科杂志,2014,16(11):1129-1132.
[16]张磊,高瑛,孙建伟,等.枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停疗效分析[J].中华实用诊断与治疗杂志,2016,30(8):789-791.