枸橼酸咖啡因联合经鼻持续气道正压通气对极低出生体质量儿呼吸管理的临床效果

目的:研究枸橼酸咖啡因联合经鼻持续气道正压通气(n CPAP)在极低出生体质量儿(VLBW)呼吸管理中的临床疗效。方法:将120例出生体质量<1 500 g的早产儿,按入院时间编号,奇数设为治疗组,偶数设为安慰剂组。治疗组给予枸橼酸咖啡因联合n CPAP进行早期呼吸支持,对照组给予等量生理盐水及n CPAP治疗。对两组患儿呼吸暂停发生率、呼吸暂停症状消失时间、呼吸机使用率、撤机时间、住院时间、支气管肺发育不良(BPD)发生率等进行统计分析。结果:两组患儿呼吸暂停发生率比较差异无统计学意义(P>0.05),但呼吸暂停症状消失时间、呼吸机使用率、撤机时间、平均住院时间、BPD发生率比较差异有统计学意义(P<0.05)。结论:枸橼酸咖啡因联合n CPAP应用于VLBW早期呼吸支持,不仅能缩短VLBW呼吸暂停持续时间,减少呼吸机使用率及使用时间,还能减少BPD发生率,能更好提高VLBW生存质量。

Using Caffeine Citrate with Nasal Continuous Positive Airway Pressure in the Respiratory Management of Very Low Birth Weight Infant

Objective: To study the clinical efficiency of applying caffeine citrate with nasal continuous positive airway pressure (nCPAP) in the management of very low birth weight infant (VLBW). Methods: 120 cases of premature infants with birth weight less than 1,500 g were divided into two groups according to admission number (odd as treatment group, even as the control group). The treatment group was given caffeine citrate with nCPAP in early respiratory management; the control group was given normal saline (NS) with nCPAP. The incidence and symptoms disappear of apnea, respirator utilization, weaning time, average hospitalized days and incidence of bronchopulmonary dysplasia (BPD) were compared between two groups. Results: The symptoms disappear of apnea, weaning time, average hospitalized days was shorter in the treatment group as compared to the control group (P<0.05). The rate of respirator utilization and incidence of BPD was lower in the treatment group as compared to the control group (P<0.05). The incidence of apnea was not different between two groups (P>0.05). Conclusion: Using caffeine citrate with nCPAP in the early respiratory management of VLBL can shorten the duration of apnea, reduce the respirator utilization rate, weaning time and the incidence of BPD, through which improve the life quality of VLBL.