早产临产产妇单剂量应用糖皮质激素的疗效研究  

Study on the efficacy of single-dose glucocorticoid on preterm labor

作　　者：黄秋香 周洁琼 钟媛媛 HUANG Qiuxiang;ZHOU Jieqiong;ZHONG Yuanyuan(Department of Obstetrics,Wuhan children′s hospital,Tongji Medical College,Huazhong University of Science&Technology/Wuhan Maternal and Child Health Hospital,Wuhan,Hubei 430015,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院/武汉市妇幼保健院产科,武汉430015

出　　处：《重庆医学》2021年第17期2972-2976,共5页Chongqing medicine

基　　金：湖北省武汉市卫生和计划生育委员会2015年度医疗卫生科研项目(WX15B10)。

摘　　要：目的探讨单剂量应用糖皮质激素在早产临产产妇中的作用。方法选取2019年该院孕28~34+6周451例早产产妇为研究对象,按地塞米松给药方式不同,分为单剂量用药、单疗程用药和未用药3组;另选35~36+6周525例早产产妇为研究对象,分单剂量用药和未用药2组。比较并分析不同孕周不同用药方式产妇的母儿结局。结果与单剂量用药产妇比较,孕28~34+6周单疗程用药产妇的羊水粪染(31.16%vs.17.19%)及新生儿心肌损害(25.36%vs.16.29%)发生率更低,未用药产妇的新生儿1 min Apgar评分[(8.75±0.16)分vs.(7.83±0.31)分]、5 min Apgar评分[(9.25±0.16)分vs.(8.67±0.21)分]更差,而新生儿呼吸系统疾病(32.61%vs.54.35%)及颅内出血(2.17%vs.9.78%)发生率升高,差异有统计学意义(P<0.05)。与单剂量用药产妇比较,孕35~36+6周未用药产妇的新生儿5 min Apgar评分[(9.65±0.12)分vs.(9.24±0.11)分]更差,新生儿转科率(25.97%vs.35.21%)更高,差异有统计学意义(P<0.05)。结论早产产妇单剂量应用糖皮质激素能适度改善预后,可作为单疗程用药的有效补充方式。Objective To investigate the efficacy of single-dose glucocorticoid on preterm labor.Methods A total of 451 preterm labor with 28-34+6 weeks in hospital in 2019 were selected as the research objects.According to the different administration methods of dexamethasone,they were divided into three groups:single-dose medication,single-course medication and no medication;another 525 preterm labor with 35-36+6 weeks were also selected as the research objects,and they were divided into two groups:single-dose medication and no medication.Compared and analyzed the maternal and child outcomes of women with different medications in different gestational weeks.Results Compared with single-dose medication,the incidence of amniotic fluid fecal staining(31.16%vs.17.19%)and neonatal myocardial damage(25.36%vs.16.29%)were lower in single-course medication preterm labor with 28-34+6 weeks.Apgar scores became worse in neonates of no medication pregnancy at 1 min[(8.75±0.16)points vs.(7.83±0.31)points]and 5 min[(9.25±0.16)points vs.(8.67±0.21)points],while the incidences of neonatal respiratory diseases(32.61%vs.54.35%)and intracranial hemorrhage(2.17%vs.9.78%)increased,the difference was statistically significant(P<0.05).Compared with single-dose medication,5 min Apgar score[(9.65±0.12)points vs.(9.24±0.11)points]was worse and the rate of neonatal transfer was higher(25.97%vs.35.21%)in no medication preterm labor with 35-36+6 weeks,the difference was statistically significant(P<0.05).Conclusion Single-dose glucocorticoid in preterm labor can moderately improve the prognosis and can be used as an effective supplement for a single course of medication.

关 键 词：早产 糖皮质激素 阴道微生态 胎膜早破 产褥感染 

分 类 号：R714.4[医药卫生—妇产科学]