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目的比较枸橼酸咖啡因与氨茶碱治疗早产儿原发性呼吸暂停的临床疗效及其对智能发育的影响。方法选择2013年12月至2014年12月在我院珠江新城院区新生儿病房收治的原发性呼吸暂停早产儿,采用枸橼酸咖啡因注射液治疗,治愈出院,并在高危儿门诊随访者为咖啡因组;随机数字法抽取2011年12月至2013年12月同在我院珠江新城院区新生儿病房收治的原发性呼吸暂停早产儿,采用氨茶碱注射液治疗治愈出院,并在高危儿门诊规律随访者为氨茶碱组。比较两组治疗效果及患儿校正月龄6、12月时的智能发育情况。结果两组各纳入150例患儿。咖啡因组吸氧时间[(119.1±100.2)h比(156.5±134.1)h]、无创机械通气时间[(107.4±100.2)h比(156.7±139.8)h]、有创机械通气时间[(146.4±122.6)h比(270.9±257.2)h]短于氨茶碱组,差异均有统计学意义(P<0.05)。咖啡因组与氨茶碱组比较,动脉导管未闭(24.0%比45.3%)、支气管肺发育不良(9.3%比21.3%)发生率低于氨茶碱组,差异有统计学意义(P<0.05)。校正月龄6月时咖啡因组大运动、精细运动、个人社交发育商均高于氨茶碱组,校正月龄12月时咖啡因组大运动、精细运动、语言、适应性发育商均高于氨茶碱组,差异均有统计学意义(P<0.05)。结论枸橼酸咖啡因治疗早产儿原发性呼吸暂停的疗效优于氨茶碱,并有利于促进早产儿的智能发育。
Objective To compare the clinical efficacy of citrate caffeine and aminophylline in the treatment of premature infants with primary apnea and their effects on intelligence development. Methods Preterm infants with primary apnea who were admitted to neonatal ward of Zhujiang New Town Hospital from December 2013 to December 2014 were treated with citrate caffeine injection and were cured and followed up Who were caffeine; random number method extraction December 2011 to December 2013 with our hospital Zhujiang New City Hospital neonatal ward admitted to the primary apnea premature children, the use of aminophylline injection cured cured, And in high-risk children clinically follow-up for the aminophylline group. The therapeutic effects of both groups were compared with those of children aged 6 and 12 months of age. Results Both groups included 150 children. The time of oxygen inhalation in the caffeine group was (119.1 ± 100.2) h (156.5 ± 134.1) h, the duration of noninvasive mechanical ventilation was (107.4 ± 100.2) h (156.7 ± 139.8 h), the duration of invasive mechanical ventilation was ± 122.6) h ratio (270.9 ± 257.2) h] was shorter than that of aminophylline group, the difference was statistically significant (P <0.05). Compared with aminophylline group, the incidence of patent ductus arteriosus (24.0% vs 45.3%) and bronchopulmonary dysplasia (9.3% vs 21.3%) in caffeine group was lower than that in aminophylline group (P < 0.05). Correction of 6-month-old caffeine group of large exercise, fine exercise, personal social development were higher than the aminophylline group, correction of caffeine group at 12 months of caffeine large exercise, fine exercise, language, adaptive development of high In the aminophylline group, the differences were statistically significant (P <0.05). Conclusions Citrate caffeine is superior to aminophylline in the treatment of premature infants with primary apnea and is beneficial to the intelligent development of premature infants.