| In recent years,with the adjustment of the national fertility policy,the number of high-risk maternal women has increased greatly,and the incidence of preterm birth has also increased.The continuous improvement of perinatal treatment technology has enabled more and more preterm infants with small gestational age and low birth weight to survive,but these preterm infants are often accompanied with serious complications such as bronchopulmonary dysplasia,cerebral palsy,etc,which seriously affect the life quality of children.As these child will always be admitted to hospital due to respiratory infections and brain damage,the financial burden and mental stress of children's families will increase.Therefore,the problem of long-term prognosis of preterm infants is receiving more and more attention.Caffeine is often used for the treatment of apnea in clinical practice.There is no report indicating that there is a minimum gestational age restriction,so it is often used in preterm infants.As it has a long half-life and is easy to apply,it has been used in clinical practice for more than 40 years.The security has been widely verified.Bronchopulmonary dysplasia(BPD)is a common complication of very low birth weight infants.The independent factors related to morbidity include gestational age,birth weight,infectious pneumonia,patent ductus arteriosus,mechanical ventilation,antibiotic application,etc.The prevalence rate of preterm infants in China is more than 10%,which is one of the diseases that seriously affect the quality of life of preterm infants.In recent years,the prevention and treatment of BPD has begun to attract more attention.At present,relevant studies have shown that caffeine can not only treat apnea in preterm infants,but also improve the success rate of weaning,and reduce the occurrence of bronchopulmonary dysplasia,hypoxemia and patent ductus arteriosus,as well as certain neuroprotective effects,which has attracted more and more attention.ObjectiveTo explore the preventive effect of early application of caffeine citrate on the bronchopulmonary dysplasia and the effect on lung function in preterm infants.Methods150 preterm infants with gestational age less than 32 weeks and weight less than1500 g admitted to our school from October 2017 to June 2018 were selected as subjects.According to the principle of randomized control,they were divided into caffeine citrate group.(76 cases)and control group(74 cases).In the caffeine citrate group,children were given intravenous caffeine citrate within 72 hours after birth,the control group was given sterile water for injection,and the control group was given aminophylline in the presence of apnea.The incidence of bronchopulmonary dysplasia(BPD)in the preterm infants was counted.The subjects were tested for tidal breathing and pulmonary function at 40 weeks of gestational age,and the differences between the two groups were analyzed.Result1.There were no differences in gender,birth gestational age,birth weight,PS application,Apgar score and other high risk factors in the two groups of preterm infants.The duration of assisted ventilation in the caffeine group was 128.58±98.73 h,the control group was 172.32±124.30 h,the incidence of BPD in the caffeine group was 27.6%,and the control group was 43.2%.The duration of assisted ventilation and the incidence of BPD in the caffeine group both were lower than the control group(P<0.05).2.The TV function of TV,VPTE/VE,TPTEE/TE,TEF25,TEF50 and TEF75 in the caffeine group were higher than those in the control group(P<0.05),and the RR was lower than the control group(P<0.05).3.There are no statistics on the differences between other two groups of preterm infants such as retinopathy of prematurity(ROP),neonatal necrotizing enterocolitis(NEC),intracranial hemorrhage(ICH),periventricular white matter softening(PVL),sepsis,etc.Academic significance(P>0.05).ConclusionEarly application of caffeine citrate can reduce the incidence of BPD in preterm infants,shorten the time of assisted ventilation,and improve tidal breathing and lung function. |
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