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目的:研究枸橼酸咖啡因联合经鼻持续气道正压通气(n CPAP)在极低出生体质量儿(VLBW)呼吸管理中的临床疗效。方法:将120例出生体质量<1 500 g的早产儿,按入院时间编号,奇数设为治疗组,偶数设为安慰剂组。治疗组给予枸橼酸咖啡因联合n CPAP进行早期呼吸支持,对照组给予等量生理盐水及n CPAP治疗。对两组患儿呼吸暂停发生率、呼吸暂停症状消失时间、呼吸机使用率、撤机时间、住院时间、支气管肺发育不良(BPD)发生率等进行统计分析。结果:两组患儿呼吸暂停发生率比较差异无统计学意义(P>0.05),但呼吸暂停症状消失时间、呼吸机使用率、撤机时间、平均住院时间、BPD发生率比较差异有统计学意义(P<0.05)。结论:枸橼酸咖啡因联合n CPAP应用于VLBW早期呼吸支持,不仅能缩短VLBW呼吸暂停持续时间,减少呼吸机使用率及使用时间,还能减少BPD发生率,能更好提高VLBW生存质量。
Objective: To investigate the clinical efficacy of citrate caffeine combined with nasal continuous positive airway pressure (nCPAP) in respiratory management of very low birth weight infants (VLBW). Methods: 120 premature infants with birth weight <1 500 g were enrolled according to the time of admission. The odd number was used as the treatment group and the even number as the placebo group. The treatment group was given citrate caffeine n CPAP early respiratory support, the control group was given equal amount of saline and n CPAP treatment. The incidences of apnea, disappearance of apnea, ventilator utilization, weaning time, length of stay, and incidence of bronchopulmonary dysplasia (BPD) in both groups were statistically analyzed. Results: There was no significant difference in the incidence of apnea between the two groups (P> 0.05). However, there were significant differences in the disappearance of apnea symptoms, ventilator utilization, weaning time, average length of hospital stay and BPD Significance (P <0.05). CONCLUSION: Citrate caffeine combined with n CPAP for early respiratory support of VLBW can not only shorten the duration of VLBW apnea, reduce the rate and duration of ventilator use, but also reduce the incidence of BPD and improve the quality of life of VLBW.