| 摘要: |
| 目的:探讨枸橼酸咖啡因联合湿化高流量鼻导管通气（HHFNC）对早产儿反复呼吸暂停（AOP）的临床疗效。方法：回顾性分析2016年6月至2017年12月收治的胎龄30~34周反复发作呼吸暂停早产儿的临床资料，按治疗方式不同分为HHFNC联合枸橼酸咖啡因组和鼻塞式持续气道正压通气（nCPAP）联合枸橼酸咖啡因组，比较两组患儿治疗效果、不良反应、并发症发生率、住院时间及住院费用，并于矫正胎龄40周时行发育筛查测验（DST）智力量表评估，观察发育商（DQ）/智力指数（MI）的差异。结果：HHFNC组鼻黏膜损伤、腹胀的发生要低于nCPAP组（P<0.05）；HHFNC组住院费用低于nCPAP组（P<0.05）；枸橼酸咖啡因联合HHFNC治疗反复发作AOP有效率与nCPAP组比较差异无统计学意义（P>0.05）；两组患儿ROP、BPD、颅内出血等并发症发生率比较差异无统计学意义（P>0.05）；两组矫正胎龄40周的DST智力量表评估（DQ/MI）比较差异无统计学意义（P>0.05）。结论：枸橼酸咖啡因联合HHFNC治疗反复发作的AOP疗效与nCPAP相当，不良反应发生率低，费用低，同时不影响早产儿早期智力运动发育，HHFNC模式可作为早产儿反复发作AOP的一种有效治疗手段。 |
| 关键词: 枸橼酸咖啡因 湿化高流量鼻导管通气 鼻塞式持续气道正压通气 早产儿 反复发作呼吸暂停 |
| DOI：doi:10.13407/ j.cnki.jpp.1672.108X.2022.08.012 |
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| 基金项目: |
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| Humidified High Flow Nasal Cannula Combined with Caffeine Citrate in the Treatment of Recurrent Apneain Premature Infants |
| Li Jingxian, Zhang Huiqing, Zhang Yueping, He Jinxiao |
| (Xijing Hospital, Air Force Medical University of PLA, Xi’an 710001, China) |
| Abstract: |
| Objective: To explore the clinical efficacy of caffeine citrate combined with humidified high flow nasal cannula (HHFNC) in the treatment of recurrent apnea of prematurity (AOP) in premature infants. Methods: The clinical data of premature infants with recurrent apnea at gestational age from 30 to 34 weeks admitted from Jun. 2016 to Dec. 2017 were retrospectively analyzed. According to different treatment methods, all infants were divided into the HHFNC combined with caffeine citrate group and nasal continuous positive airway pressure (nCPAP) combined with caffeine citrate group. The treatment effects, adverse drug reactions, incidence of complications, length of stay and hospitalization cost were compared between two groups. The developmental screening test (DST) intelligence scale was performed at 40 weeks of corrected gestational age, and the difference of development quotient (DQ)/mental index (MI) was observed. Results: The incidence of nasal mucosal injury and abdominal distension in the HHFNC group was lower than that in the nCPAP group (P<0.05). The hospitalization cost in the HHFNC group was lower than that in the nCPAP group (P<0.05). There was no statistically significant difference in the effective rate of caffeine citrate combined with HHFNC in the treatment of recurrent AOP compared with the nCPAP group (P>0.05). There was no significant difference in the incidence of retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), intracranial hemorrhage and other complications between two groups (P>0.05). There was no statistically significant difference in DST intelligence scale DQ/MI between two groups at 40 weeks of corrected gestational age (P>0.05). Conclusion: The efficacy of caffeine citrate combined with HHFNC in the treatment of recurrent AOP is comparable to that of nCPAP, with low incidence of adverse drug reactions and low cost, while not affecting the early intellectual development of preterm infants, and HHFNC combined with caffeine citrate can be used as an effective treatment for recurrent AOP in preterm infants. |
| Key words: caffeine citrate humidification high flow nasal cannula nasal continuous positive airway pressure premature infants recurrent apnea |
