早期或晚期使用枸橼酸咖啡因防治极低出生体重儿呼吸暂停的临床分析

Clinical effect of early or late administration of caffeine citrate in prevention and treatment of apnea in very low birth weight infants

摘要:

目的 比较早期或晚期使用枸橼酸咖啡因防治极低出生体重儿呼吸暂停的临床效果。方法 选取2015年6月至2017年5月于新生儿重症监护室住院治疗的极低出生体重儿共82例为研究对象，按开始使用枸橼酸咖啡因的日龄分为早期治疗组（日龄 < 3 d）（n=22）和晚期治疗组（3 d ≤ 日龄<10 d）（n=60），回顾性收集并比较两组患儿围产期的基本情况、治疗过程情况及临床结局。结果 早期治疗组的出生体重明显低于晚期治疗组（P=0.004）；早期治疗组机械通气时间及吸氧时间明显短于晚期治疗组（P < 0.05）；早期治疗组支气管肺发育不良（BPD）的发生率明显低于晚期治疗组（P=0.032）。其余基本情况、治疗过程情况及临床结局在两组间比较差异均无统计学意义（P > 0.05）。结论 早期使用枸橼酸咖啡因可改善极低出生体重儿的预后。

Abstract:

Objective To study the clinical effect of early or late administration of caffeine citrate in the prevention and treatment of apnea in very low birth weight (VLBW) infants.Methods A total of 82 VLBW infants who were hospitalized and treated in the neonatal intensive care unit between June 2015 and May 2017 were enrolled. According to the age in days when caffeine citrate treatment was started, they were divided into early treatment group (< 3 days) with 22 infants and late treatment group (3- < 10 days) with 60 infants. A retrospective analysis was performed for their clinical data. The two groups were compared in terms of general information during the perinatal period, treatment process, and clinical outcome.Results Compared with the late treatment group, the early treatment group had a significantly lower birth weight (P=0.004), significantly shorter durations of mechanical ventilation and oxygen inhalation (P < 0.05), and a significantly lower incidence rate of bronchopulmonary dysplasia (P=0.032). There were no significant differences in other general information, treatment process, and clinical outcome between the two groups (P > 0.05).Conclusions Early administration of caffeine citrate can improve the prognosis of VLBW infants.