不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停的疗效观察

Efficacy of Different Maintenance Doses of Caffeine Citrate in the Treatment of Apnea in Preterm Infants

摘要: 目的：观察不同维持剂量的枸橼酸咖啡因治疗早产儿呼吸暂停的疗效。方法：选取2021年6月~2023年6月于安徽医科大学附属巢湖医院出生并直接转入新生儿病房住院治疗的115例呼吸暂停的早产儿作为研究对象。依据使用咖啡因维持剂量不同，分为3组，分别是高维持剂量组：枸橼酸咖啡因注射液10 mg/kg经静脉泵入治疗；中维持剂量组：7.5 mg/kg；低维持剂量组：5.0 mg/kg。比较三组不同维持剂量枸橼酸咖啡因治疗早产儿呼吸暂停的疗效观察指标、不良反应及并发症发生情况。定量资料多组间均数的比较采用方差分析，方差分析多组间两两比较采用LSD法。定性资料以例数(n, %)表示，多组间样本率的比较采用x²检验。结果：1. 高维持剂量组的呼吸暂停次数、咖啡因用药时间、用氧时间、机械通气时间和住院时间均低于中维持剂量组和低维持剂量组，差异有统计学意义。2. 三组患儿心动过速和喂养不耐受发生率的差异均没有统计学意义。3. 三组患儿支气管肺发育不良、颅内出血、早产儿视网膜病变和新生儿高血糖发生率的差异均没有统计学意义。结论：高维持剂量枸橼酸咖啡因治疗AOP的疗效更好，且不会增加不良反应及并发症的发生。

Abstract: Objective: To observe the efficacy of different maintenance doses of caffeine citrate in the treatment of apnea of prematurity. Method: A total of 115 preterm infants with apnea who were born in Chaohu Hospital affiliated to Anhui Medical University from June 2021 to June 2023 and were directly transferred to the neonatal ward for inpatient treatment were selected as the research subjects. According to the different maintenance doses of caffeine, they were divided into 3 groups, which were the high maintenance dose group: caffeine citrate injection 10 mg/kg was pumped intravenously for treatment; medium maintenance dose group: 7.5 mg/kg; low maintenance dose group: 5.0 mg/kg. The efficacy of different maintenance doses of caffeine citrate in the treatment of apnea in preterm infants was compared between the three groups, and the observation indicators, adverse reactions and complications were compared. Quantitative data: ANOVA was used for comparison of means between multiple groups, and LSD method was used for comparison of pairwise between multiple groups for ANOVA. Qualitative data were expressed in the number of cases (n, %) and the chi-square test was used for comparison of sample rates between multiple groups. Results: 1. The number of apnea, caffeine medication time, oxygen time, mechanical ventilation time and hospital stay in the high maintenance dose group were lower than those in the medium maintenance dose group and the low maintenance dose group, and the difference was statistically significant. 2. There was no significant difference in the incidence of tachycardia and feeding intolerance among the three groups. 3. There were no significant differences in the incidence of bronchopulmonary dysplasia, intracranial hemorrhage, retinopathy of prematurity and neonatal hyperglycemia between the three groups. Conclusion: High maintenance doses of caffeine citrate were more effective in the treatment of AOP and did not increase the occurrence of adverse reactions and complications.