| 梁文英,黄水霞.枸橼酸咖啡因联合俯卧位经鼻持续气道正压通气治疗早产儿频发呼吸暂停 56例[J].安徽医药,2020,24(5):1022-1026. |
| 枸橼酸咖啡因联合俯卧位经鼻持续气道正压通气治疗早产儿频发呼吸暂停 56例 |
| Clinical study of citrate caffeine combined with prone position nasal continuous positive airway pressure in the treatment of 56 premature infants with frequent apnea |
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| DOI：10.3969/j.issn.1009?6469.2020.05.044 |
| 中文关键词: 呼吸暂停 连续气道正压通气 俯卧位 呼吸功能试验 婴儿，早产 枸橼酸咖啡因 神经发育结局 |
| 英文关键词: Apnea Continuous positive airway pressure Prone position Respiratory function tests Infant,premature Caffeine citrate Neurodevelopmental outcome |
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| 中文摘要: |
| 目的探讨枸橼酸咖啡因联合俯卧位经鼻持续气道正压通气( nCPAP)在早产儿频发呼吸暂停治疗中的价值。方法选取 2016年 5月至 2018年 4月洛阳市妇幼保健院频发呼吸暂停早产儿 112例，按照随机数字表法分为观察组与对照组，每组 56例。给予常规治疗，出现呼吸暂停表现时两组均实施俯卧位 nCPAP，在此基础上，对照组给予氨茶碱治疗，观察组给予枸橼酸咖啡因治疗。对比两组临床疗效、治疗情况、停药后肺功能［呼吸频率( RR)、潮气量( TV)、每分通气量( MV)及 25%、50%、75%潮气量时呼气流速( TEF25、TEF50、TEF75)］指标、用药期间不良反应发生率，随访至治疗后 6个月，对比两组神经发育结局［运动发育指数( PDI)与智力发育指数( MDI)］。结果(1)临床疗效:观察组治疗总有效率 94.64%(53/56)高于对照组 82.14%(46/ 56)(P＜0.05)；(2)治疗情况:治疗 7d后观察组呼吸暂停发生频率( 1.01±0.27)次 /天低于对照组( 1.92±0.48)次 /天( P＜0.05)，且观察组 nCPAP通气时间［(153.39±45.36)h比( 227.83±72.11)h］、有创通气时间［(36.01±10.24)h比( 109.54±23.41)h］、用氧时间［(141.69±24.02)h比( 242.68±34.12)h］及用药时间［(197.25±34.21)h比( 288.41±43.58)h］短于对照组( P＜0.05)；(3)肺功能:两组停药后 RR比较差异无统计学意义( P＞0.05)观察组 TV、MV及 TEF25、TEF50、TEF75高于对照组( P＜0.05)；(4)安全性:用药期间观察组不良反应发生率 10.71%(6/56)低于，对照组 28.57%(16/56)(P＜0.05)；(5)神经发育结局:治疗后 6个月，观察组 MDI(114.26±17.12)分及 PDI评分( 109.26±18.36)分高于对照组( 101.83±16.47)、(97.59±20.03)分( P＜0.05)。结论枸橼酸咖啡因联合俯卧位 nCPAP治疗早产儿频发呼吸暂停效果显著，有利于减少呼吸暂停发作，缩短住院时间，改善病儿肺功能及神经发育结局，且安全性较高。 |
| 英文摘要: |
| Objective To investigate the value of citrate caffeine combined with prone nasal continuous positive airway pressure(nCPAP)in the treatment of frequent apnea in premature infants.Methods A total of 112 cases of frequent apnea premature in?fants admitted to Luoyang Women and Children Health Hospital from May 2016 to April 2018 were selected and divided into obser?vation group and control group according to random number table method，with 56 cases in each group.Both groups were given rou?tine treatment and nCPAP in the prone position when apnea occurred.On this basis，the control group was given aminophylline treat?mentand the observation group was given caffeine citrate treatment.Compare the clinical efficacy，treatment status，lung function in? dicatorsafter respiratory arrest［respiration rate(RR)，tidal volume(TV)，ventilation per minute(MV)and exhalation flow rate at 25%，50%，75% tidal volume(TEF25，TEF50，TEF75)］，the incidence of adverse reactions during the treatment，follow?up to 6 months after treatment，compared the two groups of neurodevelopmental outcomes［motor development index(PDI)and mental de? velopment index(MDI)］ .Results(1)Clinical efficacy:The total effective rate of observation group was 94.64%(53/56)，which was higher than that of the control group 82.14%(46/56)( P＜0.05)；(2)Treatment:7 days after treatment，the frequency of apne? aoccurrence of the observation group was lower than that of the control group［(1.01±0.27)vs.(1.92±0.48)，P＜0.05］，and the nC? PAP ventilation time［(153.39±45.36)h vs.(227.83±72.11)h］，invasive ventilation time［(36.01±10.24)h vs.(109.54±23.41)h］，ox? ygen time［(141.69±24.02)h vs.(242.68±34.12)h］and medication time［(197.25±34.21)h vs.(288.41±43.58)h］of the observation group were shorter than those of the control group(P＜0.05)；(3)Pulmonary function:There was no significant difference in the posterior RR between the two groups(P＞0.05).The TV，MV and TEF25，TEF50 and TEF75 in the observation group were higher than those in the control group(P＜0.05)(.4)Safety:The incidence of adverse reactions in the observation group was 10.71%(6/ 56)，which was lower than that the control group 28.57%(16/56)( P＜0.05)；(5)Neurodevelopmental outcome:At 6 months after treatment，the MDI［( 114.26±17.12)vs.(101.83±16.47)］ and PDI scores［( 109.26±18.36)vs.(97.59±20.03)］ of the observation group were higher than those of the control group(P＜0.05).Conclusion The combination of caffeine citrate and prone position nCPAP has a significant effect on frequent apnea in premature infants，which is beneficial to reduce apnea episodes，shorten hospi? tal stay，improve lung function and neurodevelopmental outcome，and hashigher safety. |
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