Study On Etiology And Intervention Of Apnea In Premature Infants

Objective:1.To analyze the etiology of AOP.2.To explore the intervention methods of different types of AOP.3.To compare the efficacy,adverse reactions and short-term prognosis of caffeine citrate and aminophylline in the treatment of AOP in very low birth weight infants.Methods:1.A total of 225 premature infants who were hospitalized in the Department of Neonatal Pediatrics of Fujian Maternal and Child Health Hospital from January 1,2017 to December 31,2018 were collected as the case group.225 premature infants without apnea were collected by random table method as the control group.A total of 35 very low birth weight preterm infants with AOP treated with aminophylline were collected as aminophylline group.60 very low birth weight premature infants with AOP treated with citrate caffeine whose gestational age and birth weight were similar to those in aminophylline group were selected as caffeine group,2.The onset of apnea in premature infants was analyzed,and the incidence of apnea in different gestational ages was compared.3.Univariate analysis was carried out on the related factors that may lead to AOP,and the statistically significant related factors of AOP were included in Logistic regression analysis to find out the etiology of AOP.4.The intervention methods of AOP were retrospectively analyzed to explore the intervention methods of different types of AOP.5.To compare the efficacy,adverse reactions and short-term prognosis of caffeine citrate and aminophylline in the treatment of AOP in very low birth weight infants.6.SPSS 23.0 software was used for statistical analysis,and the counting data were expressed as n(%).Chi-square test,Fisher exact probability method,continuity correction were used to compare the two group.The normal distribution in the measurement data was expressed by SX ±,and t-test was used for comparison between the two groups.Those that do not conform to the normal distribution are expressed by M(Q1,Q2),and the Mann-Whienty U test is used.Logistic regression analysis was used to analyze the etiology of apnea in premature infants.P <0.05 means the difference is statistically significant.Results:1.Most of the first apnea occurs within 7 days after birth(55.1%),followed by 14 days after birth(25.8%),and rarely after 14 days(19.1%).The younger the gestational age,the higher the incidence of apnea in premature infants(P <0.05).2.Logistic regression analysis of the causes of apnea in premature infants: birth weight<1500g,gestational age<34 weeks,gastroesophageal reflux disease,hypothermia,hs PDA and hyperkalemia were the causes of apnea in premature infants.3.Intervention of apnea in premature infants: 225 premature infants with AOP were immediately given tactile stimulation such as dorsal support and foot bouncing.If cyanosis occurred,oxygen was pressurized by balloon immediately.If apnea occurs repeatedly,respiratory stimulants or respiratory support are given,and premature infants with secondary apnea need to take corresponding interventions to treat their primary diseases according to the etiology.4.Comparison of efficacy,adverse reactions and short-term prognosis between caffeine citrate and aminophylline in the treatment of AOP in very low birth weight infants:there was no significant difference in the efficacy of caffeine citrate and aminophylline in the treatment of AOP in very low birth weight infants.However,the incidence of adverse drug reactions of vomiting,tachycardia and hyperglycemia in caffeine group were significantly lower than that in aminophylline group,The average hospital stay and the incidence of BPD in the caffeine group were significantly lower than those in the aminophylline group.Conclusions:1.Apnea is a common symptom in premature infants.Most of the first apnea occurs within 7 days after birth(55.1%).The younger the gestational age,the higher the incidence of apnea in premature infants2.Hypothermia,birth weight <1800g,gestational age<34 weeks,hyperkalemia,gastroesophageal reflux disease and hs PDA were independent risk factors for apnea in premature infants.Clinically,attention should be paid to the identification of premature infants prone to apnea,close monitoring of their vital signs and early diagnosis and treatment.3.When AOP occurs,we can use tactile stimulation,respiratory center stimulants,auxiliary ventilation and other intervention measures to reduce the occurrence of apnea,secondary apnea should also pay attention to the active treatment of its primary disease.4.There is no significant difference in the efficacy of caffeine and aminophylline in the treatment of AOP in very low birth weight infants,but compared with aminophylline,caffeine has a lower incidence of adverse reactions in very low birth weight infants of vomiting,tachycardia and hyperglycemia,which means caffeine has higher safety,caffeine can shorten the average hospital stay,reduce the incidence of BPD and improve the short-term prognosis of very low birth weight infants.