标题：枸橼酸咖啡因联合机械通气治疗极早产儿急性呼吸窘迫综合征疗效观察

      作者：黄莹，卢燕玲，卢珍通    东莞市人民医院儿科，广东 东莞 523000

      卷次： 2021年32卷15期

      【摘要】 目的 观察枸橼酸咖啡因联合机械通气治疗极早产儿急性呼吸窘迫综合征(NRDS)的临床效果。方法 选择2019年1月至2020年7月在东莞市人民医院儿科治疗的60例确诊为NRDS的极早产儿作为研究对象，采用随机数表法分为观察组和对照组各30例。对照组患儿给予机械通气加猪肺磷脂注射液治疗，观察组在对照组治疗的基础上联合枸橼酸咖啡因治疗。比较两组患儿的血气分析指标、上机时间、用氧时间、呼吸暂停≥3次/d的发作天数、呼吸暂停消失时的纠正胎龄、NRDS严重并发症肺气漏和肺出血发生率。结果 治疗72 h后，两组患儿的氧分压和血氧饱和度水平较治疗前均明显上升，二氧化碳分压较治疗前均明显下降，观察组患儿氧分压和血氧饱和度分别为(83.86±5.54) mmHg、(95.34±3.12)%，明显高于对照组的(80.71±5.48) mmHg、(90.04±4.76)%，二氧化碳分压为(41.51±5.12) mmHg，明显低于对照组的(45.68±5.78) mmHg，差异均有统计学意义(P<0.05)；观察组患儿上机时间、用氧时间及呼吸暂停≥3次/d的发作天数分别为(5.04±2.01) d、(12.21±1.01) d、(3.71±0.56) d，明显少于对照组的(6.08±1.05) d、(14.89±1.87) d、(4.73±0.64) d，差异均有统计学意义(P<0.05)；两组患儿的呼吸暂停消失时的纠正胎龄比较差异无统计学意义(P>0.05)；观察组和对照组患儿的并发症总发生率分别为6.67%和10.00%，差异无统计学意义(P>0.05)。结论 枸橼酸咖啡因联合机械通气治疗极早产儿NRDS可有效改善患儿血气水平，缩短上机时间，减少呼吸暂停的发生率，缩短总用氧时间，值得临床推广应用。
      【关键词】 急性呼吸窘迫综合征；枸橼酸咖啡因；机械通气；极早产儿；疗效
      【中图分类号】 R722.1 【文献标识码】 A 【文章编号】 1003—6350（2021）15—1979—03

Effect of caffeine citrate combined with mechanical ventilation on very premature infants with acute respiratorydistress syndrome.
HUANG Ying, LU Yan-ling, LU Zhen-tong. Department of Pediatrics, Dongguan People's Hospital,Dongguan 523000, Guangdong, CHINA
【Abstract】 Objective To observe the clinical effect of caffeine citrate combined with mechanical ventilation inthe treatment of very preterm infants with neonatal respiratory distress syndrome (NRDS). Methods A total of 60 verypreterm infants diagnosed with NRDS treated in the Department of Pediatrics, Dongguan People's Hospital from January2019 to July 2020 were selected and divided into the observation group and the control group according to random num-ber table method, with 30 cases in each group. The control group was treated with mechanical ventilation, and the obser-vation group was treated with caffeine citrate on the basis of the control group. The clinical efficacy of the two groups af-ter 72 hours of treatment was compared, the blood gas analysis indexes, tidal volume, minute ventilation volume, peaktime ratio, apnea times, apnea disappearance time just got on the ventilator and after 72 hours of treatment and adversereactions of the two groups were compared. Results The oxygen partial pressure and blood oxygen saturation of thetwo groups were significantly increased, while the carbon dioxide partial pressure was significantly decreased; the oxy-gen partial pressure and blood oxygen saturation of the observation group were (83.86±5.54) mmHg, (95.34±8.12)%,which were significantly higher than corresponding (80.71±5.48) mmHg and (90.04±8.76)% of the control group; thepartial pressure of carbon dioxide of the observation group was (41.51±5.12) mmHg, which was significantly lower than(45.68±5.78) mmHg in the control group (P<0.05); the machine time, oxygen time, apnea times and corrected gestation-al age weeks in the observation group were (5.04±2.01) d, (12.21±1.01) d, (3.71±0.56) d, which were significantly lessthan corresponding (6.08±1.05) d, (14.89±1.87) d, (4.73±0.64) d (all P<0.05); there was no statistically significant differ-ence in corrected gestational age at the time of apnea disappearance between the two groups (P>0.05). The total inci-dence of adverse reactions were 10.00% in the control group and 6.67% in the observation group, with no significant dif-ference (P>0.05). Conclusion Caffeine citrate combined with mechanical ventilation is effective in the treatment ofvery premature infants, which can effectively improve the blood gas level and lung function.
      【Key words】 Neonatal acute respiratory distress syndrome (NRDS); Caffeine citrate; Mechanical ventilation;Very premature infants; Curative effect