咖啡因联合氨茶碱治疗早产儿呼吸暂停的疗效观察

目的探讨枸橼酸咖啡因注射液联合氨茶碱注射液治疗早产儿呼吸暂停的临床疗效。方法选取2017年1月—2018年1月成都市中西医结合医院收治的早产儿呼吸暂停患儿132例为研究对象,使用随机数表法分为对照组和治疗组,每组各66例。对照组患儿静脉泵入氨茶碱注射液,首次剂量为5 mg/kg,12 h后以2 mg/kg的剂量持续静脉注射,1次/12 h。治疗组患儿在对照组治疗的基础上静脉注射枸橼酸咖啡因注射液,首次剂量20 mg/kg,24 h后给予维持量5 mg/kg,1次/d。两组患儿均连续治疗1周后停药。观察两组的临床疗效,比较两组的临床症状和不良反应情况。结果治疗后,对照组和治疗组的总有效率分别为74.24%、89.40%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患儿72 h内发生呼吸暂停次数、24 h内呼吸暂停消失时间、治疗期间总用氧时间、需要有创通气例数均低于对照组,两组比较差异具有统计学意义(P0.05)。治疗组发生心率加快、电解质紊乱、体温增高的情况明显低于对照组,两组比较差异有统计学意义(P0.05)。结论枸橼酸咖啡因注射液联合氨茶碱注射液治疗早产儿呼吸暂停具有较好的临床疗效,可改善临床症状,安全性较好,具有一定的临床推广应用价值。

Clinical observation of caffeine combined with aminophylline in treatment of apnea in premature infants

Objective To investigate the clinical effect of Caffeine Citrate Injection combined with Aminophylline Injection in treatment of apnea in premature infants. Methods Premature infants (132 cases) with apnea in Chengdu Integrated TCM & Western Medicine Hospital from January 2017 to January 2018 were randomly divided into control and treatment groups, and each group had 66 cases. Patients in the control group were intravenous pumping administered with Aminophylline Injection, first dosage 5 mg/kg, after 12 h, continuous intravenous injection of 2 mg/kg, once every 12 h. Patients in the treatment group were po administered with Caffeine Citrate Injection on the basis of the control group, first dosage 20 mg/kg, after 24 h, maintenance dosage 5 mg/kg, once daily. Patients in two groups were treated for 1 week. After treatment, the clinical efficacies were evaluated, and clinical symptoms and adverse reactions in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 74.24% and 89.40%, respectively, and there was difference between two groups (P<0.05). After treatment, the frequency of apnea within 72 h, the disappearance time of apnea within 24 h, the total oxygen consumption time during treatment, and the number of cases requiring invasive ventilation in the treatment group were significantly lower than those in the control group, and there was difference between two groups (P<0.05). After treatment, the incidents of heart rate acceleration, electrolyte disturbance, body temperature increase in the treatment group were significantly lower than those in the control group, and there was difference between two groups (P<0.05). Conclusion Caffeine Citrate Injection combined with Aminophylline Injection has clinical curative effect in treatment of apnea in premature infants, can improve clinical symptoms, with good safety, which has a certain clinical application value.