中国学术期刊网络出版总库入编期刊
CNKI中文期刊全文数据库全文收录期刊
中国核心期刊(遴选)数据库全文收录期刊
万方数据——数字化期刊群收录期刊
中文科技期刊数据库全文收录期刊

主管:陕西省卫生健康委员会
主办:西安心身医学研究所
   西安交通大学第一附属医院
国际标准刊号:ISSN2096—1413
国内统一刊号:CN61—1503/R

枸橼酸咖啡因预防早产儿呼吸暂停的临床效果观察

张小玲

(西安高新医院新生儿科,陕西 西安,710075)

浏览次数:196次 下载次数:367次

摘要:

目的 观察使用枸橼酸咖啡因预防早产儿呼吸暂停(apnea of prematurity, AOP)的有效性与安全性。方法 将我院新生儿 科收治的胎龄小于30 周的61 例早产儿随机分为预防治疗组(30 例)和常规治疗组(31 例)。预防治疗组出生后24 h 内静脉 给予枸橼酸咖啡因20 mg/kg,隔24 h 后给予维持量10 mg/kg。常规治疗组在呼吸暂停后给予相同剂量枸橼酸咖啡因。观察两 组早产儿的治疗效果。结果预防治疗组的治疗有效率为93.33%,高于常规治疗组的64.52%(P<0.05)。两组早产儿的各不良 反应发生率比较,差异无统计学意义(P>0.05)。预防治疗组BPD、IVH 及ROP 发生率均低于常规治疗组(P<0.05)。结论 早期 使用枸橼酸咖啡因可降低早产儿发生AOP 的次数,安全性好,可明显降低早产儿的相关并发症发生率。

关键词:枸橼酸咖啡因;早产儿;呼吸暂停

中图分类号:R722.6文献标志码:A文章编号:2096-1413(2018)01-0090-03

    Clinical effect observation of citric acid caffeine on preventing apnea in premature infants

    ZHANG Xiao-ling
    (Neonatology Department, Gaoxin Hospital of Xi``an, Xi``an 710075, China)

    ABSTRACT: Objective To observe the efficacy and safety of citric acid caffeine on apnea of prematurity (AOP) in premature infants. Methods A total of 61 preterm infants with gestational age less than 30 weeks in neonatal department of our hospital were randomly divided into preventive treatment group (30 cases) and conventional treatment group (31 cases). The preventive treatment group was given citric acid caffeine 20 mg/kg intravenously within 24 h after birth and given maintenance dose of 10 mg/kg after 24 h. The conventional treatment group was given the same dose of citric acid caffeine after apnea. The treatment effects in both groups were compared. Results The effective rate of the preventive treatment group was 93.33%, which was higher than 64.52% of the conventional treatment group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The incidences of BPD, IVH and ROP were lower than those of the conventional treatment group (P<0.05). Conclusion Early use of citric acid caffeine can reduces the number of apneas in preterm infants, with high safety, which can significantly reduce the incidences of related complications and adverse reactions.
    KEYWORDS: citric acid caffeine; preterm infants; apnea

    参考文献:
    [1] 邵肖梅.实用新生儿学[M].北京:人民卫生出版社,2011:245-247.
    [2] MORIETTE G,LESCURE S,EL AM,et al.Apnea of prematurity: what``s new?[J].Arch Pediatr,2010,17(2):186-190.
    [3] 赵婧,母得志.早产儿呼吸暂停诊治进展[J].临床儿科杂志,2012,30(3):291-294.
    [4] POETS CF.Apnea of prematurity: What can observational studies tellus about pathophysiology?[J].Sleep Med,2010,11(7):701-707.
    [5] LORCH SA,SRINIVASAN L,ESCOBAR GJ.Epidemiology of apnea and bradycardia resolution in premature infants [J].Pediatrics,2011, 128(2):e366-e373.
    [6] 毛健.早产儿呼吸暂停与间歇性缺氧[J].中国小儿急救医学,2014,21(10):617-621.
    [7] ZHAO J,GONZALEZ F,MU D.Apnea of prematurity: from cause totreatment[J].Eur J Pediatr,2011,170(9):1097-1105.
    [8] 田欣,韦红.早产儿呼吸暂停发生机制的研究进展[J].重庆医学,2010,39(17):2387-2389.
    [9] STOKOWSKI LA.A primer on Apnea of prematurity[J].Adv NeonatalCare,2005,5(3):171-174.
    [10] MATHEW OP.Apnea of prematurity: pathogenesis and managementstrategies[J].J Perinatol,2011,31(5):302-310.
    [11] 唐晓艳,王丹华.咖啡因在新生儿中的应用进展[J].中国新生儿杂志,2014,29(5):343-346.
    [12] STEER PA,HENDERSON-SMART DJ.Caffeine versus theophylline for apnea in preterm infants[M].Cochrane Database Syst Rev,2000, (2):CD000273.
    [13] KUMRAL A, TUZUN F, YESILIRMAK DC,et al.Genetic basis of apnoea of prematurity and caffeine treatment response: role of adenosine receptor polymorphisms: genetic basis of apnoea of prematurity[J].Acta paediatr,2012,101(7):e299-e303.
    [14] GRAY PH,FLENADY VJ,CHARLES BG,et al.Caffeine citrate for very preterm infants: effects on development, temperament and behaviour[J].J Paediatr Child Health,2011,47(4):167-172.
    [15] MARCUS CL,MELTZER LJ,ROBERTS RS,et al.Long-term effects of caffeine therapy for apnea of prematurity on sleep at school age [J].Am J Respir Crit Care Med,2014,190(7):791-799.

上一篇甲氨蝶呤联合米非司酮在异位妊娠中的应用研究

下一篇盐酸氨溴索雾化吸入辅助治疗新生儿肺炎的疗效观察