枸橼酸咖啡因应用于极早早产儿的临床疗效分析
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摘要
目的观察枸橼酸咖啡因应用于极早早产儿的临床疗效。方法选择2013年5月至2018年4月郑州市第一人民医院收治的极早早产儿42例为研究对象,随机分为观察组和对照组各21例。对照组应用氨茶碱并联合使用呼吸机治疗,并定期监测氨茶碱血药浓度,使血药浓度维持在5～10 mg/L;观察组应用枸橼酸咖啡因并联合使用呼吸机进行治疗,观察比较两组患儿的临床疗效、治疗后再次插管次数、撤机后呼吸暂停发生次数、呼吸机通气时间及不良反应。结果治疗后观察组临床总有效率为90.4%(19/21),显著高于对照组61.9%(13/21),差异有统计学意义(P<0.05)。两组治疗拔管后再次插管次数、呼吸暂停发生次数、呼吸机通气时间比较,差异均有统计学意义(P<0.05),两组治疗后再次插管上机指标均较治疗前降低,差异均有统计学意义(P<0.05);观察组治疗后临床疗效指标均优于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论枸橼酸咖啡因应用于极早早产儿临床疗效优于氨茶碱。
Objective To observe the clinical efficacy of caffeine citrate in very early preterm infants.Methods From May 2013 to April 2018, 42 cases of very early preterm infants admitted to Zhengzhou First People's Hospital were selected as the subjects, and they were randomly divided into 21 cases in the observation group and 21 cases in the control group. The control group was treated with aminophylline and a ventilator, and the blood concentration of aminophylline was regularly monitored, so that the blood concentration was maintained at 5 to 10 mg/L. The observation group was treated with caffeine citrate and a ventilator. Observe the clinical efficacy of the two groups, the number of reintubation after treatment, the number of apnea after withdrawal, the ventilation time and the adverse reactions.Results The total effective rate of the observation group after treatment was 90.4%(19/21), which was significantly higher than that of the control group(61.9%,13/21), and the difference was statistically significant(P<0.05). There was statistical difference between the two groups in the number of reintubation and the number of apnea after withdrawal, and the ventilation time(P<0.05). After treatment, the indicators of reintubation on the machine in both groups were lower than before treatment, and the difference was statistically significant(P<0.05). The clinical efficacy of the observation group was better than that of the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of ADR between the two groups(P<0.05).Conclusion Citrate coffee for an early clinical efficacy is better than that of aminophylline.
Objective To observe the clinical efficacy of caffeine citrate in very early preterm infants.Methods From May 2013 to April 2018, 42 cases of very early preterm infants admitted to Zhengzhou First People's Hospital were selected as the subjects, and they were randomly divided into 21 cases in the observation group and 21 cases in the control group. The control group was treated with aminophylline and a ventilator, and the blood concentration of aminophylline was regularly monitored, so that the blood concentration was maintained at 5 to 10 mg/L. The observation group was treated with caffeine citrate and a ventilator. Observe the clinical efficacy of the two groups, the number of reintubation after treatment, the number of apnea after withdrawal, the ventilation time and the adverse reactions.Results The total effective rate of the observation group after treatment was 90.4%(19/21), which was significantly higher than that of the control group(61.9%,13/21), and the difference was statistically significant(P<0.05). There was statistical difference between the two groups in the number of reintubation and the number of apnea after withdrawal, and the ventilation time(P<0.05). After treatment, the indicators of reintubation on the machine in both groups were lower than before treatment, and the difference was statistically significant(P<0.05). The clinical efficacy of the observation group was better than that of the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of ADR between the two groups(P<0.05).Conclusion Citrate coffee for an early clinical efficacy is better than that of aminophylline.
引文
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[8] 李文斌,常立文,刘伟,等.氨茶碱联合纳洛酮防治早产儿呼吸暂停与枸橼酸咖啡因疗效比较[J].中华实用儿科临床杂志,2014,29(18):1381-1384.
[9] Henderson-Smart DJ, Steer PA.Caffeine versus theophylline for apnea in preterm infants[J]. Cochrane Database Syst Rev,2010,(1):CD000273.
[10] Henderson-Smart DJ, Davis PG.Prophylactic methylxanthines for endotracheal extubation in preterm infants[J]. Cochrane Database Syst Rev,2010,(12):CD000139.
[11] 李建业,朱永耀,戴正亮.氨茶碱联合纳洛酮在早产儿原发性呼吸暂停治疗中的应用[J].中国实用医药,2012,7(14):49-51.
[12] 李兆权.固尔苏联合鼻塞式持续气道正压通气治疗早产儿呼吸窘迫综合征72例[J].航空航天医药,2010,21(11):1995.
[13] 罗春艳.枸橼酸咖啡因对新生儿呼吸窘迫综合征呼吸力学的影响[J].世界最新医学信息文摘,2017,17(65):15-16.
[14] 张雪峰,童笑梅,叶鸿瑁.早产儿原发性呼吸暂停研究进展[J].国外医学(儿科学分册),2004,31(3):134-137.
[2] 易湘平,胡淑丽,李和勤.小剂量固尔苏联合CPAP治疗新生儿呼吸窘迫综合征临床观察[J].吉林医学,2010,31(9):1202-1203.
[3] 秦素芳,蔡家平,严璃.肺表面活性物质联合鼻塞持续正压通气治疗新生儿呼吸窘迫综合征临床观察[J].儿科药学杂志,2012,18(1):14-16.
[4] 李兆权.固尔苏联合鼻塞式持续气道正压通气治疗早产儿呼吸窘迫综合征72例[J].航空航天医药,2010,21(11):1995.
[5] 栾永刚,董玉斌,曹亚芹.肺表面活性物质联合机械通气治疗新生儿呼吸窘迫综合征40例临床分析[J].现代中西医结合杂志,2010,19(29):3726-3727.
[6] 张少华.肺泡表面活性物质治疗呼吸窘迫综合征的临床观察[J].中国医药指南,2012,7(26):221.
[7] 唐仕芳,赵锦宁,沈洁,等.经鼻间歇和持续气道正压通气治疗新生儿呼吸窘迫综合征的Meta分析[J].中国循证儿科杂志,2011,6(4):255-263.
[8] 李文斌,常立文,刘伟,等.氨茶碱联合纳洛酮防治早产儿呼吸暂停与枸橼酸咖啡因疗效比较[J].中华实用儿科临床杂志,2014,29(18):1381-1384.
[9] Henderson-Smart DJ, Steer PA.Caffeine versus theophylline for apnea in preterm infants[J]. Cochrane Database Syst Rev,2010,(1):CD000273.
[10] Henderson-Smart DJ, Davis PG.Prophylactic methylxanthines for endotracheal extubation in preterm infants[J]. Cochrane Database Syst Rev,2010,(12):CD000139.
[11] 李建业,朱永耀,戴正亮.氨茶碱联合纳洛酮在早产儿原发性呼吸暂停治疗中的应用[J].中国实用医药,2012,7(14):49-51.
[12] 李兆权.固尔苏联合鼻塞式持续气道正压通气治疗早产儿呼吸窘迫综合征72例[J].航空航天医药,2010,21(11):1995.
[13] 罗春艳.枸橼酸咖啡因对新生儿呼吸窘迫综合征呼吸力学的影响[J].世界最新医学信息文摘,2017,17(65):15-16.
[14] 张雪峰,童笑梅,叶鸿瑁.早产儿原发性呼吸暂停研究进展[J].国外医学(儿科学分册),2004,31(3):134-137.