摘要
目的探讨在早产儿呼吸暂停患儿中应用枸橼酸咖啡因治疗的作用和价值。方法纳入2018年7月-2020年2月郁南县人民医院产科收治的确诊为早产儿呼吸暂停患儿58例,按分层随机法分为对照组与观察组,各29例。对照组通过氨茶碱治疗,观察组通过枸橼酸咖啡因治疗,对比分析两组症状改善指标(呼吸暂停消失时间、用氧时间、住院时间及住院费用),用药前后血生化指标[血清β-内啡肽(β-EP)、血浆内皮素-1(ET-1)、血清一氧化氮(NO)],患儿脑神经发育情况(中国儿童发展量表中智力指数、运动指数)、用药后肺功能指标(呼吸频率、每分钟通气量、潮气量、达峰时间比、达峰容积比)及用药后不良反应发生率。结果观察组患儿症状改善指标中呼吸暂停消失时间、用氧时间、住院时间,不良反应发生率10.34%均低于对照组(P<0.05);治疗后观察组血生化指标ET-1、NO及β-EP水平改善效果优于对照组(P<0.05);观察组治疗后智力指数和运动指数评分,用药后每分钟通气量、潮气量、达峰时间比、达峰容积比均高于对照组(P<0.05);两组患儿住院费用与用药后呼吸频率组间比较无显著差异(P>0.05)。结论在早产儿呼吸暂停患儿治疗中应用枸橼酸咖啡因可促进患儿脑神经发育,且能明显缩短患儿的呼吸暂停消失时间、用氧时间及住院时间,改善肺功能指标,促患儿体内β-内啡肽、血内皮素及一氧化氮水平改善,规避不良反应,值得应用。
Objective To investigate effect and value of caffeine citrate in treatment of premature infants with apnea.Methods The paper chose 58 cases of premature infants with apnea diagnosed in obstetrics department of Yunan County People's Hospital from July 2018 to February 2020,and divided them into control group and observation group randomLy,with 29 cases in each group.Control group was treated with aminophylline and observation group with caffeine citrate.Symptom improvement indexes(disappearance time of apnea,oxygen use time,hospitalization time and expenses)and blood biochemical indexes[serumβ-endorphins(β-EP),plasma endothelin-1(ET-1),serum nitric oxide(NO)],brain nerve development of infants(intelligence index and exercise index of development scale of Chinese children),pulmonary function indexes(respiratory rate,ventilation per minute,tidal volume,peak time ratio and peak volume ratio)after medication,and incidence of adverse reactions after medication were compared and anzlyzed between two groups.Results Disappearance time of apnea,time of oxygen use,time of hospitalization and adverse reactions incidence in observation group were 10.34%,lower than control group(P<0.05).After treatment,ET-1,NO andβ-EP improvement effect was better than control group(P<0.05);scores of intelligence index and exercise index in observation group were higher than control group(P<0.05);there was no significant difference between two groups in hospitalization expenses and respiratory rate after medication(P>0.05).Conclusion Caffeine citrate can promote development of brain nerves,significantly shorten disappearance time of apnea,time of oxygen use and length of stay of premature infants with apnea,improve indexes of lung function,promote development of brain nerves,improve levels ofβ-endorphin,endothelin and nitric oxide,to avoid adverse reactions,which was worthy of application.
作者
李凤勤
LI Fengqin(Pediatrics Department,Yunan County People's Hospital,Yunan,Guangdong,527100)
出处
《智慧健康》
2022年第21期156-160,165,共6页
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