陈炎

【摘要】 目的：探究枸橼酸咖啡因治疗胎龄28～32周早产儿呼吸暂停（AOP）的临床疗效。

方法：选取2015年11月-2017年11月本院收治的65例早产儿。按照治疗方案不同将其分为对照组

32例和观察组33例。对照组使用枸橼酸咖啡因常规剂量，观察组使用枸橼酸咖啡因高剂量。比较两组心率、血压、呼吸暂停次数、用氧时间、住院时间及并发症情况。结果：观察组治疗后的呼吸暂停次数、用氧时间及住院时间分别为（1.0±0.2）次/d、（4.2±1.3）d及（28.6±2.8）d，均低于对照组的（1.5±0.3）次/d、（6.3±1.2）d及（35.6±3.2）d，比较差异均有统计学意义（P<0.05）；观察组治疗后的心率、平均收缩压、平均舒张压分别为（128.57±10.33）次/min、（64.22±5.24）mm Hg及（45.27±2.95）mm Hg，明顯高于对照组的（120.83±10.16）次/min、（61.13±4.15）mm Hg及（42.15±2.71）mm Hg，比较差异均有统计学意义（P<0.05）；两组并发症发生率比较差异无统计学意义（P>0.05）。结论：枸橼酸咖啡因治疗胎龄28～32周AOP的临床疗效显著，可有效减少早产儿的呼吸暂停次数、用氧时间及住院时间，但患儿的心率加快，血压有所升高，并发症发生率未发生明显变化。

【关键词】 早产儿； 呼吸暂停； 枸橼酸咖啡因

Clinical Observation of Caffeine Citrate in Treatment of Apnea of Prematurity with Gestational Age of 28-32 Weeks/CHEN Yan.//Medical Innovation of China，2018，15（27）：116-120

【Abstract】 Objective：To explore the clinical efficacy of Caffeine Citrate in treatment of apnea of prematurity（AOP） with gestational age of 28-32 weeks.Method：A total of 65 premature infants admitted to our hospital from November 2015 to November 2017 were selected.According to different treatment regimens，they were divided into 32 cases of control group and 33 cases of observation group.The control group was given Caffeine Citrate regular dose，while observation group was given high dose Caffeine Citrate.The heart rate，blood pressure，apnea frequency，oxygen consumption time，hospitalization time and complications between two groups were compared.Result：After treatment，the apnea frequency，oxygen consumption time and hospitalization time in observation group were（1.0±0.2）times/d，（4.2±1.3） d and（28.6±2.8）d，were lower than（1.5±0.3）times/d，（6.3±1.2）d，（35.6±3.2）d in control group，the differences were statistically significant（P<0.05）.After treatment，the heart rate，mean systolic blood pressure and mean diastolic blood pressure of observation group were（128.57±4.2）times/min，（64.22 ±5.24）mm Hg and（45.27±2.95） mm Hg，were significantly higher than（120.83±10.16）times/min，（61.13 ±4.15） mm Hg and （42.15±2.71） mm Hg in control group，the differences were statistically significant（P<0.05）.The incidence of complications in two groups were compared，the differences were not statistically significant（P>0.05）.Conclusion：The clinical efficacy of Caffeine Citrate in treatment of AOP with gestational age of 28-32 weeks is significant，it can effectively reduce the number of apnea，oxygen time and time of hospitalization in premature infants，but the heart rate of the children is quicker，the blood pressure is rised，and the incidence of complications has not changed obviously.

【Key words】 Preterm infants； Apnea； Caffeine Citrate

First-authors address：Xinyi Maternal and Child Health Care Hospital，Xinyi 525300，China

doi：10.3969/j.issn.1674-4985.2018.27.031

早产儿主要指出生时胎龄不足37周、出生体重不超过2 500 g、身长不足47 cm的活产婴儿[1]。早产儿的呼吸中枢发育不完善，呼吸浅快且不规则，甚至出现呼吸暂停现象[2]。早产儿呼吸暂停（AOP）指胎龄<37周的早产儿呼吸停止时间超过20 s，或呼吸停止不足20 s但伴有经皮氧饱和度下降（SpO2≤85%且持续时间≥4 s）和/或心动过缓（心率≤100次/min且时间持續≥4 s）[3]。胎龄越小呼吸暂停发生的概率越高，且通常发生于刚出生的几天。如不及时发现病情和处理，很可能导致早产儿脑缺氧损伤，甚至发生猝死[4]。……