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目的:比较两种不同维持剂量枸橼酸咖啡因防治早产儿呼吸暂停的疗效。方法:选择2014年1月至2015年8月在北京大学深圳医院住院且胎龄≤32周的原发性呼吸暂停早产儿72例,随机分为A组[枸橼酸咖啡因维持量为20 mg/(kg·d)]和B组[枸橼酸咖啡因维持量为10 mg/(kg·d)]各36例,比较两组呼吸暂停频率及辅助通气情况,观察患儿支气管肺发育不良、坏死性小肠结肠炎、早产儿视网膜病及严重脑室内出血等并发症发生情况及药物相关不良反应。结果:A组在呼吸暂停时间及氧疗时间均短于B组(P<0.05);两组n CPAP辅助通气时间及拔管后重新插管例数比较差异无统计学意义(P>0.05);两组主要不良反应(心动过速、喂养不耐受、体质量增加时间)比较差异均无统计学意义(P>0.05);A组患儿恢复出生体质量时间长于B组(P<0.05);两组主要并发症发生率比较差异无统计学意义(P>0.05)。结论:20 mg/(kg·d)维持剂量咖啡因能改善早产儿呼吸暂停情况且不良反应发生率未明显增加,但是否为最优剂量仍需进一步研究。
Objective: To compare the efficacy of two different maintenance doses of citrate caffeine in the prevention and treatment of apnea in preterm infants. Methods: From January 2014 to August 2015, 72 patients with primary apnea and premature infants who were hospitalized at Peking University Shenzhen Hospital and whose gestational age was ≤32 weeks were randomly divided into group A [maintenance dose of citrate caffeine 20 mg / (kg · d)] and group B [the maintenance dose of citric acid caffeine was 10 mg / (kg · d)] in each group. The apnea frequency and assisted ventilation were compared between the two groups to observe the bronchopulmonary development Adverse, necrotizing enterocolitis, retinopathy of prematurity and severe intraventricular hemorrhage and other complications and drug-related adverse reactions. Results: The time of apnea and oxygen therapy in group A were shorter than those in group B (P <0.05). There was no significant difference in nACAP-assisted ventilation time and number of re-intubation after extubation between two groups (P> 0.05) There was no significant difference in the main side effects (tachycardia, feeding intolerance, body weight increasing time) between the two groups (P> 0.05). The recovery time of birth weight in group A was longer than that in group B ). There was no significant difference in the incidence of major complications between the two groups (P> 0.05). CONCLUSION: Caffeine at a maintenance dose of 20 mg / (kg · d) can improve apnea status in preterm infants with no significant increase in the incidence of adverse reactions. However, further study is needed to determine whether optimal doses of caffeine are needed.