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目的对比枸橼酸咖啡因与氨茶碱防治极低出生体重儿呼吸暂停的疗效。方法以本院2013年3月-2015年3月收治的100例极低出生体重儿作为试验对象。其中以2013年3月-2014年3月收治的极低出生体重儿48例为对照组:使用氨茶碱治疗,首剂负荷剂量5mg/kg,30min静脉泵入,12h后给予维持剂量2mg/kg,每12h1次,静脉泵入;以2014年3月-2015年3月收治的极低出生体重儿52例为观察组:使用枸橼酸咖啡因治疗,首剂负荷剂量20mg/kg,静脉泵入,24h后给予维持剂量5mg/kg,每24h1次,静脉泵入。比较两组患儿呼吸暂停发生率、氧疗时间、达到全肠道喂养的时间、脑室内出血、坏死性小肠炎、早产儿视网膜病、支气管肺发育不良等并发症的发生率及病死率。结果1)观察组早产儿呼吸暂停发生率较对照组低,且差异有统计学意义(P<0.05);2)两组患儿脑室内出血、支气管肺发育不良、早产儿视网膜病的发生率及辅助通气率低于对照组,且差异有统计学意义[9(18.7%)vs 3(5.7%),χ2=3.98,P<0.05];[19(39.6%)vs 10(19.2%),χ2=5.05,P<0.05];[10(20.8%)vs 2(3.8%),χ2=6.85,P<0.05];[18(37.5%)vs10(19.2%),χ2=4.04,P<0.05];3)两组患儿在坏死性小肠炎的发生率、病死率、氧疗时间、达到全肠道喂养的时间等方面差异无统计学意义(P均>0.05)。结论枸橼酸咖啡因在防治早产儿呼吸暂停疗效及改善早产儿近期预后优于氨茶碱,但远期预后有待于进一步随访。
Objective To compare the effects of caffeine citrate and aminophylline in the prevention and treatment of apnea of very low birth weight infants. Methods A total of 100 very low birth weight children admitted to our hospital from March 2013 to March 2015 were selected as the test subjects. Among them, 48 cases of very low birth weight infants admitted from March 2013 to March 2014 were used as control group: aminophylline treatment, the first dose of 5mg / kg, 30min intravenous infusion, 12h after the maintenance dose of 2mg / kg every 12h, intravenous infusion; March 2016 March 2015 admitted to the very low birth weight infants 52 cases for the observation group: the use of citrate caffeine treatment, the first dose of 20mg / kg load, intravenous Pump in, after 24h given to maintain the dose of 5mg / kg, every 24h1 times, intravenous injection. The incidence and mortality of complications such as apnea incidence, oxygen therapy time, total enteral feeding time, intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia were compared between the two groups. Results 1) The incidence of apnea in observation group was lower than that in control group, and the difference was statistically significant (P <0.05); 2) The incidence of intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity in both groups and The rate of assisted ventilation was lower than that of the control group, and the difference was statistically significant (9 (18.7%) vs 3 (5.7%), χ2 = 3.98, P <0.05] P <0.05]; [18 (37.5%) vs10 (19.2%), χ2 = 4.04, P <0.05] ; 3) There was no significant difference between the two groups in the incidence of necrotizing enterocolitis, case fatality rate, duration of oxygen therapy and time of full gut feeding (all P> 0.05). Conclusion Citrate caffeine is superior to aminophylline in preventing and treating apnea in preterm infants and improving the prognosis of preterm infants. However, long-term prognosis remains to be followed up.