枸橼酸咖啡因与氨茶碱治疗早产儿呼吸暂停的疗效比较

Jian-ping Zhu
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摘要

目的比较枸橼酸咖啡因与氨茶碱治疗过早呼吸暂停的疗效。方法选取临汾市人民医院2013年1月至2018年12月收治的呼吸暂停早产儿230例,按随机数字表法随机分为两组,每组115例。枸橼酸咖啡因组用枸橼酸咖啡因治疗,氨茶碱组用氨茶碱治疗。比较两组患者相关临床指标、精神发展指数评分(MDI)、精神运动发展指数评分(PDI)、并发症及不良反应情况。结果枸橼酸咖啡因组呼吸支持时间、总辅助通气时间、机械通气时间、鼻间歇正压通气(NIPPV)时间、鼻持续气道正压通气(nCPAP)时间、氧疗时间、用药时间、住院时间、住院费用均显著低于氨茶碱组。6个月和12个月校正后的MDI评分和PDI评分均显著高于氨茶碱组;支气管肺发育不良(BPD)、动脉导管未闭(PDA)及脑损伤发生率显著低于氨茶碱组;喂养不耐受、多尿、低钾血症发生率均显著低于氨茶碱组,差异均有统计学意义(P<0.05)。结论与氨茶碱相比,枸橼酸咖啡因对早期呼吸暂停的疗效更稳定,安全性更高。关键词:枸橼酸咖啡因;氨茶碱;早产儿;呼吸暂停
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Comparison of efficacy of caffeine citrate versus aminophylline in the treatment of premature infants with apnea
Objective To compare the effect of caffeine citrate and aminophylline in the treatment of premature apnea. Methods A total of 230 premature infants with apnea admitted to Linfen People’s Hospital from January 2013 to December 2018 were randomly divided into two groups according to the random number table method, with 115 cases in each group. Caffeine citrate group was treated with caffeine citrate, and aminophylline group was treated with aminophylline. The related clinical indicators, mental development index score (MDI score), psychomotor development index score (PDI score), complications and adverse reactions were compared between the two groups. Results Respiratory support time, total assisted ventilation time, mechanical ventilation time, nasal intermittent positive pressure ventilation (NIPPV) time, nasal continuous positive airway pressure (nCPAP) time, oxygen therapy time, medication time, hospitalization time and hospitalization cost in the citrate caffeine group were significantly lower than those in the aminophylline group. The corrected MDI scores and PDI scores at 6 months and 12 months were significantly higher than those in the aminophylline group; the incidence of bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA) and brain injury was significantly lower than those of the aminophylline group; feeding intolerance, and the incidence of polyuria and hypokalemia were significantly lower than those of the aminophylline group, and the difference were statistically significant (P<0.05). Conclusions Compared with aminophylline, caffeine citrate has more stable effect and higher safety on premature apnea. Key words: Caffeine citrate; Aminophylline; Premature infant; Apnea
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