首页|以停氧为目标导向确定咖啡因治疗早产儿呼吸暂停的疗程研究

以停氧为目标导向确定咖啡因治疗早产儿呼吸暂停的疗程研究

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目的 评估以停氧为目标导向确定咖啡因疗程的方案对氧依赖早产儿的临床受益.方法 选取2021年10月至2023年9月入住该院新生儿科219例早产儿,根据随机数字法分为干预组(以停氧为目标导向咖啡因治疗,n=108)和对照组(常规咖啡因治疗,n=111).比较两组呼吸暂停复发、重复使用咖啡因、停用咖啡因时间、用氧时间及住院时间等指标差异.结果 与对照组相比,干预组停用咖啡因纠正胎龄更大[(35.9±1.7)周vs.(34.4±1.5)周],住院时间更长[(64.62±20.60)d vs.(57.96±17.68)d],差异有统计学意义(P<0.05).两组呼吸暂停复发率、咖啡因重复使用率、用氧时间、中重度支气管肺发育不良发生率、机械通气使用率、住院费用,以及≥Ⅱ级坏死性小肠结肠炎、喂养不耐受、心动过速发生率及体重增长速度比较,差异无统计学意义(P>0.05).结论 以停氧为目标导向确定咖啡因疗程的方案不能减少早产儿的呼吸暂停复发风险及氧依赖,且有可能延长住院时间.
Study on treatment course of determining caffeine for treating apnea of prematurity with oxygen discontinuation as target orientation
Objective To evaluate the clinical benefit of caffeine treatment regimen determined based on oxygen discontinuation as target orientation for oxygen-dependent preterm infants.Methods A total of 219 preterm infants admitted to the neonatal department of this hospital from October 2021 to September 2023 were selected and divided into the intervention group (caffeine treatment targeting weaning oxygen,n=108) and the control group (routine caffeine treatment,n=111).The differences in the apnea recurrence,reuse of caffeine,time of caffeine discontinuation,duration of using oxygen and hospitalization duration were compared between the two groups.Results Compared with the control group,the correcting fetal age by stopping caffe-ine in the intervention group was greater[(35.9±1.7)weeks vs.(34.4±1.5)weeks],hospitalization dura-tion was longer[(64.62±20.60)d vs.(57.96±17.68)d],and the differences were statistically significant (P<0.05).The apnea recurrence rate,reuse rate of caffeine,duration of oxygen use,incidence rate of moder-ate to severe bronchopulmonary dysplasia,mechanical ventilation use rate,hospitalization expenses,≥grade Ⅱ necrotizing enterocolitis,feeding intolerance,tachycardia incidence rate and body weight increase velocity had no statistical differences between the two groups (P>0.05).Conclusion Determining the caffeine treatment course regimen by oxygen discontinuation as target orientation could not reduce the recurrent risk of preterm infants apnea recurrence risk,which could prolong the hospitalization duration.

apnea of prematuritycaffeineoxygen dependencehospitalization durationbronchopulmo-nary dysplasia

王建辉、董文辉、范颖、冉丽红、史源

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重庆医科大学附属儿童医院新生儿科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室,重庆 400014

儿童感染与免疫罕见病重庆市重点实验室,重庆 400014

早产儿呼吸暂停 咖啡因 氧依赖 住院时间 支气管肺发育不良

国家重点研发计划重庆市科卫联合医学科研项目重庆医科大学未来医学青年创新团队支持计划

2022YFC27048032022MSXM137W0134

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(15)
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