未足月胎膜早破411例妊娠结局临床分析  

The Clinical Analysis of Pregnancy Outcome of 411 Cases of Preterm Premature Rupture of Membrane

作　　者：聂爱宏[1] 周小飞[2] 向爱清[2] 

机构地区：[1]丰城市人民医院妇产科,江西丰城331139 [2]江西省妇幼保健院产科,南昌330006

出　　处：《实用临床医学（江西）》2007年第10期61-62,65,共3页Practical Clinical Medicine

摘　　要：目的分析不同孕周胎膜早破性早产（preterm premature rupture of membrane,PPROM）妊娠结局以及产前使用糖皮质激素干预对早产新生儿结局的影响。方法：对411例未足月PPROM病例的临床资料进行回顾性分析,比较不同孕周PPROM及产前是否使用糖皮质激素干预治疗的各种早产儿结局。结果：〈34孕周PPROM的新生儿体重、呼吸窘迫综合症（RDS）、窒息发生率、死亡率均明显高于34^＋1-36^＋6孕周PPROM者（P〈0.001）。32-34孕周组PPROM的新生儿重度窒息发生率、RDS、死亡率在糖皮质激素干预组明显低于对照组,两组间比较差异有显著性（P〈0.05）。28-31^＋6孕周组及34^＋1-36^＋6孕周组PPROM新生儿结局的各项指标在干预组与对照组间无显著差异（P〉0.05）。结论：对于〈34孕周的PPROM宜采取积极期待治疗,延长孕周,降低新生儿死亡率。32-34孕周的PPROM产前使用糖皮质激素干预能显著改善新生儿结局。Objective： To understand the impact of preterm premature rupture of membrane （PPROM） of different gestational age and antenatal treatment with corticosteroid on the neonatal outcome. Methods：The clinical data of 411 cases of preterm premature rupture of membrane were analyzed retrospectively, and neonatal outcome were compared between different gestational age and antenatal treatment with corticosteroid. Results： The neonatal birth weight, RDS, asphyxia and death in the group less than 34 gestation age was significantly higher than in the group of 34^＋1-36^＋6 gestational age（P〈0. 001）. The incidence of sever asphyxia,RDS and death in the treatment group was significantly lower than in the control group of 32-34 gestational age（P〈 0.05）. All index about the neonatal outcome in the treatment group had no significant difference with control group between 28-31^＋6 and 34^＋1 -36^＋6 gestational age（P〉0.05）. Conclusion： In patients with PPROM with a gestational age less than 34, a waiting management scheme is advised to prolong gestational age and decrease neonatal morbidity, antenatal treatment with corticosteroid could improve the neonatal outcome of PPROM with 32-34 gestational age.

关 键 词：早产 胎膜早破 糖皮质激素 新生儿结局 

分 类 号：R714.433[医药卫生—妇产科学]