目的分析不同剂量枸橼酸咖啡因对极低出生体重儿拔管撤机疗效的影响。方法将2015年5月-2016年1月广州市妇女儿童医疗中心NICU收治的生后呼吸机辅助通气的极低出生体重早产儿随机分为大剂量枸橼酸咖啡因组和维持剂量组,在计划拔管前给予不同剂量咖啡因(20 mg/kg和10 mg/kg)治疗,观察拔管后30 min内的脉氧饱和度最低值和经皮二氧化碳分压最高值以及拔管后24 h的通气模式。结果两组患儿临床特征及病情无明显差异(P>0.05),大剂量组拔管后具有更好的脉氧饱和度[85(69~94)%vs 69(57~80)%,M=112,P=0.047],两组之间经皮二氧化碳分压无明显差异(P>0.05),两组24 h的通气模式具有统计学差异(P=0.024)。结论极低出生体重儿拔管撤机前适当地增加枸橼酸咖啡因的剂量有助于改善拔管后的通气模式。 Objective To analyze the effects of different doses of citrate caffeine on the efficacy of extubation and weaning in very low birth weight infants. Methods The neonatal ventilator assisted ventilation of very low birth weight preterm infants admitted to NICU of Guangzhou Women and Children Medical Center from May 2015 to January 2016 were randomly divided into high dose of citrulline citrate group and maintenance dose group Different levels of caffeine (20 mg / kg and 10 mg / kg) were given before extubation. The lowest values ​​of oxygen saturation and percutaneous carbon dioxide partial pressure were observed within 30 min after extubation. Ventilation mode. Results There was no significant difference between the two groups in clinical features and disease (P> 0.05). The higher dose group had better pulse oximetry after extubation [85 (69-94)% vs 69 (57-80)%, M = 112, P = 0.047]. There was no significant difference between the two groups in the partial pressure of percutaneous carbon dioxide (P> 0.05). There was a significant difference in ventilation patterns between the two groups at 24 hours (P = 0.024). CONCLUSIONS: Increasing doses of caffeine citrate before extubation is very helpful for improving ventilation patterns after extubation.