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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

37

期数:

2020年4

页码:

374-377

栏目:

临床研究

出版日期:

2020-04-05

文章信息/Info

Title:

Clinical effect of caffeine for treatment of preterm infants with apnea

作者:

贾晓慧¹; 董　枫¹; 刘艳红²

（1.郑州人民医院妇产科，河南　郑州　450000；2.郑州人民医院新生儿科，河南　郑州　450000）

Author(s):

JIA Xiaohui¹; DONG Feng¹; LIU Yanhong²

(1.Department of Gynecology and Obstetrics,Zhengzhou People′s Hospital,Zhengzhou 450000,Henan Province,China；2.Department of Neonatology,Zhengzhou People′s Hospital,Zhengzhou 450000,Henan Province,China)

关键词:

咖啡因; 氨茶碱; 早产儿; 呼吸暂停; 安全性

Keywords:

caffeine; aminophylline; premature; apnea; safety

分类号:

R722.6

DOI:

10.7683/xxyxyxb.2020.04.017

文献标志码:

A

摘要:

目的　观察咖啡因治疗早产儿呼吸暂停的临床效果及安全性。方法　选择2018年1月至2019年6月郑州人民医院收治的74例原发性呼吸暂停早产儿为观察对象，按随机数字表法分为对照组和观察组，每组37例。对照组患儿按5 mg·kg^-1的负荷量将氨茶碱注射液溶入50 g·L^-1葡萄糖溶液10 mL中缓慢静脉滴注，滴注时间1 h；12 h 后按2 mg·kg^-1的维持量将氨茶碱注射液溶入50 g·L^-1葡萄糖溶液4 mL中缓慢静脉滴注，滴注时间20 min，每日2次。观察组患儿按20 mg·kg^-1的负荷量将枸橼酸咖啡因注射液溶入50 g·L^-1葡萄糖注射液5 mL中静脉滴注，滴注时间30 min；24 h后按5~10 mg·kg^-1的维持量将枸橼酸咖啡因注射液加入50 g·L^-1葡萄糖注射液2 mL中静脉滴注，滴注时间10 min，每日1次。记录患儿呼吸暂停持续时间、发作次数及症状消失时间。分别检测2组患儿治疗前及治疗72 h的动脉血氧饱和度（SaO₂）、动脉血氧分压（PaO₂）、心率（HR），并观察临床疗效和治疗过程中不良反应发生情况。结果　观察组患儿呼吸暂停持续时间和症状消失时间短于对照组，发作次数少于对照组（P＜0.05）。2组患儿治疗前HR、SpO₂和PaO₂比较差异无统计学意义（P＞0.05）；治疗72 h，2组患儿HR、SpO₂和PaO₂水平均较治疗前显著升高（P＜0.05）；治疗72 h， 观察组患儿HR、SpO₂和PaO₂水平显著高于对照组（P＜0.05）。对照组和观察组患儿治疗有效率分别为78.38%（29/37）和97.29%（36/37），观察组患儿治疗有效率显著高于对照组（χ²=6.198，P＜0.05）。对照组和观察组患儿不良反应发生率分别为18.92%（7/37）和5.40%（2/37），观察组患儿不良反应发生率显著低于对照组（χ²=5.514，P＜0.05）。结论　咖啡因治疗早产儿呼吸暂停能显著缩短其呼吸暂停持续时间，降低呼吸暂停发作次数，改善血气指标，提高临床治疗效果，降低不良反应发生率。

Abstract:

Objective　To observed the efficacy and safety of caffeine for treatment of primary apnea in premature infants.Methods　Seventy-four premature infants with primary apnea admitted to Zhengzhou People′s Hospital from January 2018 to June 2019 were selected as the study objects and were divided into observation group and control group according to the random number table method,with 37 cases in each group.The premature infants in the control group were given 5 mg·kg^-1 aminophylline（the aminophylline injection was dissolved into 10 mL of 50 g·L^-1 glucose）by intravenous drip for 1 hour；after 12 hours,the premature infants were treated with aminophylline in the maintenance dose of 2 mg·kg^-1（the aminophylline injection was dissolved into 4 mL of 50 g·L^-1 glucose） by intravenous drip for 20 min，twice a day.The premature infants in the observation group were given caffeine citrate injection in the dose of 20 mg·kg^-1(the caffeine citrate injection was dissolved into 5 mL of 50 g·L^-1 glucose) by intravenous drip for 30 min;after 24 hours,the premature infants were treated with caffeine citrate injection in the maintenance dose of 5-10 mg·kg^-1(the caffeine citrate injection was dissolved into 2 mL of 50 g·L^-1 glucose) by intravenous drip for 10 min,once a day.The duration of apnea,the number of episodes and the time of disappearance of symptoms were recorded.The arterial oxygen saturation (SaO₂　),arterial oxygen pressure (PaO₂　) and heart rate (HR) were detected before and at 72 hours after treatment in the two groups.At the same time,the clinical efficacy and the occurrence of adverse reactions during treatment were also observed.Results　The duration of apnea and the time of symptoms disappearance of premature infants in the observation group were shorter than those in the control group，but the attack frequency was less than that in the control group(P<0.05).There was no significant difference in HR,SpO₂　 and PaO₂　 between the two groups before treatment(P>0.05).The HR and SpO₂　,PaO₂　 levels of preterm infants after 72 hours treatment were significantly higher than those before treatment in the two group（P＜0.05).The HR and SpO₂　,PaO₂　 levels of preterm infants in the observation group were higher than those in the control group after 72 hours treatment（P＜0.05).The total effective rate of the control group and the obsorvation group was 78.38%（29/37） and 97.29%（36/37）， respectively.The total effective rate of preterm infants in the observation group was significantly higher than that in the control group（χ²　=6.198，P＜0.05）.The incidence of adverse effect of the control group and the obsorvation group was 18.92%（7/37） and 5.40%（2/37）,respectively.The incidence of adverse effect of preterm infants in the observation group was significantly lower than that in the control group(χ²　=5.514，P<0.05)．Conclusion　Caffeine can shorten the duration of apnea and the time of symptoms disappearance，reduce the frequency of attack，improve the blood gas index，improve the clinical effect and reduce the incidence of adverse reactions of premature infants with apnea.

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更新日期/Last Update: 2020-04-05