枸橼酸咖啡因联合双水平正压通气治疗早产儿呼吸暂停疗效观察

目的:评价枸橼酸咖啡因联合双水平正压通气(DuoPAP)治疗早产儿呼吸暂停的疗效。方法:选择2014年7月至2015年6月在徐州中心医院新生儿重症监护病房(NICU)诊断为原发性早产儿呼吸暂停的早产儿58例,应用随机数字表法分为研究组20例,对照组1和对照组2各19例。在给予常规护理及一般治疗的基础之上,研究组另给予枸橼酸咖啡因联合DuoPAP,对照组1给予枸橼酸咖啡因,对照组2给予uoPAP,若上述治疗无效时,立即给予气管插管机械通气,作为抢救性治疗。比较三组患儿的总有效率、总用氧时间及住院时间、气管插管辅助通气率、早产儿并发症发生率。结果:研究组总有效率(90.0%)高于对照组1(52.6%)及对照组2(42.1%),差异有统计学意义(P<0.05);对照组1和对照组2总有效率比较差异无统计学意义(P>0.05)。研究组的总用氧时间及住院时间均短于对照组(P<0.05)。研究组气管插管机械通气率(10.0%) 低于对照组(31.6%),但差异无统计学意义(P>0.05)。三组患儿并发症发生率比较差异无统计学意义(P>0.05)。结论:枸橼酸咖啡因联合DuoPAP治疗早产儿呼吸暂停具有显著的疗效,值得临床推广应用。

Curative Effect Observation of Caffeine Citrate Combined with Duo Positive Airway Pressure in the Treatment of Apnea of Prematurity

Objective: To evaluate the effects of caffeine citrate combined with duo positive airway pressure in treatment of apnea of prematurity (AOP). Methods: Fifty-eight AOP children treated in neonatal intensive care unit (NICU) of Xuzhou Central Hospital from July 2014 to June 2015 were randomly divided into 3 groups: study group (20 cases), control group 1 (19 cases), control group 2 (19 cases). All children were received routine care and basal treatment. The children in study group were treated with caffeine citrate combined with duo positive airway pressure (DuoPAP). The children in control group 1 were treated with caffeine citrate. The children in control group 2 (19 cases) were treated with DuoPAP. If the treatment was failed, trachea cannula and mechanical ventilation were used immediately as salvage therapy. The methods of analysis of variance and chi-square test were used to analyze the total oxygen inhaling time, hospitalization time, endotracheal intubation assisted ventilation rate and occurring rate of prematurity complication. Results: The total effective rate in study group (90.0%) was higher than that in the control group 1 (52.6%) and the control group 2 (42.1%) (P<0.05). There was no significant difference between control group 1 and control group 2 (P>0.05). The total oxygen inhaling time and hospitalization time in study group were significantly shorter than the two control groups (P<0.05). The endotracheal intubation assisted ventilation rate in study group (10.0%) was lower than the control group (31.6%), there were no significant differences between three groups (P>0.05). There were no significant differences between the three groups in occurring rate ofprematurity complication (P>0.05). Conclusion: Caffeine citrate combined with DuoPAP therapy has significant clinical effect in the treatment of AOP, it is worthy of clinical promotion.