不同时间给予柠檬酸咖啡因对早产儿预后和神经发育影响的比较

中国小儿急救医学 Pub Date : 2020-02-20 DOI:10.3760/CMA.J.ISSN.1673-4912.2020.02.012

Xiaonan Li, Fa-lin Xu, Yaxuan Liu, Wenli Duan, Meng-Di Liu, Jia-xin Liu

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引用次数: 1

摘要

目的探讨不同时间给予枸橼酸咖啡因对早产儿预后及神经发育的影响。方法选取2018年1月至2018年6月在新生儿重症监护病房住院治疗的胎龄小于32周、出生体重小于1 500 g的早产儿113例。根据枸橼酸咖啡因治疗开始时间分为早期治疗组(≤1天)53例，晚期治疗组(1 ~ 10天)60例。对其临床资料进行回顾性分析。比较两组患儿的围生期情况、治疗过程及临床结果，并于12月龄时随访患儿神经发育情况。结果与晚期治疗组比较，早期治疗组机械通气时间、供氧时间、住院天数均显著缩短，支气管肺发育不良、动脉导管未闭、脑室内出血、脑室周围白质软化发生率均显著降低，两组比较差异均有统计学意义(P<0.05)。孕40周时，早期治疗组新生儿行为神经学评估评分高于晚期治疗组，两组比较差异有统计学意义(P<0.05)。早期治疗组3月龄时的心理发展指数、12月龄时的心理发展指数和精神运动发展指数均显著优于晚期治疗组，两组比较差异均有统计学意义(P<0.05)。结论早期应用枸橼酸咖啡因可改善早产儿预后，改善神经系统预后。关键词:枸橼酸咖啡因;早产儿;出生体重极低的婴儿;神经系统发育

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Comparison of the effects of caffeine citrate administering at different time on outcome and neuro-development of premature infants

Objective To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants. Methods A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old. Results Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups(P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups(P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups(P<0.05, respectively). Conclusion Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system. Key words: Caffeine citrate; Premature infant; Very low birth weight infant; Neural development

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来源期刊

中国小儿急救医学

自引率

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发文量

6226

期刊介绍： Chinese Journal of Neurology was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry. Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals, Chinese Journal of Neurology, and Chinese Journal of Psychiatry. Chinese Journal of Neurology is now indexed by EM, SCOPUS, AJ, WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 2.755 in 2017, ranking the first among all neurological and psychological journals in China and among all the 142 medical journals published by the Chinese Medical Association. The journal is available both in print and online.