CAJ | 학술논문

目的：探讨枸橼酸咖啡因在改善早产儿原发性呼吸暂停中的疗效与安全性。方法2013年10月至2014年9月本院新生儿重症监护病房收治的96例诊断有原发性呼吸暂停的早产儿入选试验,根据家属有无同意应用枸橼酸咖啡因,予非随机分为治疗组(n=51)和对照组(n=45),治疗组应用枸橼酸咖啡因治疗,对照组予安慰剂治疗,比较两组治疗的有效率、并发症等。结果两组患儿的性别、胎龄、出生体重、入院年龄、首次发生呼吸暂停日龄、氧疗方式等方面的差异均无统计学意义(P>0．05)；治疗组有效41例(80．4%,41/51),对照组有效23例(51．1%,23/45),两组差异有统计学意义(χ2=9．224,P=0．002)；治疗组支气管肺发育不良7例,动脉导管未闭7例,早产儿视网膜病变4例,脑室内出血9例；对照组发生支气管肺发育不良14例,动脉导管未闭15例,早产儿视网膜病变10例,脑室内出血20例,两组并发症比较差异有统计学意义(P<0．05)。结论枸橼酸咖啡因治疗早产儿原发性呼吸暂停疗效显著,而且有效降低支气管肺发育不良、动脉导管未闭、早产儿视网膜病变、脑室内出血等早产儿并发症的发生。
목적：탐토구연산가배인재개선조산인원발성호흡잠정중적료효여안전성。방법2013년10월지2014년9월본원신생인중증감호병방수치적96례진단유원발성호흡잠정적조산인입선시험,근거가속유무동의응용구연산가배인,여비수궤분위치료조(n=51)화대조조(n=45),치료조응용구연산가배인치료,대조조여안위제치료,비교량조치료적유효솔、병발증등。결과량조환인적성별、태령、출생체중、입원년령、수차발생호흡잠정일령、양료방식등방면적차이균무통계학의의(P>0．05)；치료조유효41례(80．4%,41/51),대조조유효23례(51．1%,23/45),량조차이유통계학의의(χ2=9．224,P=0．002)；치료조지기관폐발육불량7례,동맥도관미폐7례,조산인시망막병변4례,뇌실내출혈9례；대조조발생지기관폐발육불량14례,동맥도관미폐15례,조산인시망막병변10례,뇌실내출혈20례,량조병발증비교차이유통계학의의(P<0．05)。결론구연산가배인치료조산인원발성호흡잠정료효현저,이차유효강저지기관폐발육불량、동맥도관미폐、조산인시망막병변、뇌실내출혈등조산인병발증적발생。
Objective To investigate the clinical efficacy and safety of caffeine citrate in the treat-ment of primary apnea in premature infants. Methods A non-randomized controlled trial had been designed in which 96 premature infants would be enrolled form Oct 2013 to Sep 2014 in our hospital. According to the therapeutic strategy,the patients were divided into treatment group(n=51) and control group(n=45). The treatment group was treated with caffeine citrate,and the control group was treated with placebo. The overall response rates and the complication rates in the two groups were compared. Results The effective rate of the treatment group was 80. 4%(41/51),while the control group was 51. 1%(23/45). There was a significant difference between the two groups(χ2 =9. 224,P =0. 002). The incidence of bronchopulmonary dysplasia (7 cases vs. 14 cases),patent ductus arteriosus(7 cases vs. 15 cases),retinopathy of prematurity(4 cases vs. 10 cases),intraventricular hemorrhage(9 cases vs. 20 cases),showed significant differences between the two groups( P<0. 05 ) . Conclusion Caffeine citrate is significantly more effective than placebo in reducing apnea episodes and reduces the rate of bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity and intraventricular hemorrhage in premature infants.