胎膜早破早产的产科处理与早产儿预后的关系

Study on the Relationship between the Management of Preterm Premature Rupture of Membrances and Prognosis of Premature

目的:探讨胎膜早破早产(PPROM)的产科处理与早产儿的围产结局,提高早产儿的生存质量。方法:将早产患者分为PPROM组和非PPROM组,予以保护性治疗,比较2组孕龄、体质量及早产儿生存状况。结果:PPROM与非PPROM的发生率为8.3%和8.5%、平均孕龄分别是34.5周和34.3周,阴道产分别为61例(56.0%)和41例(36.6%),2组比较差别有统计学意义(P<0.01)。合并症分别为48例(42.1%)和49例(40.5%);破膜后48h内分娩的71例,孕龄、体质量分别是34.8周和2435g,超过48h分娩的41例,孕龄、体质量分别是33.7周和2063g,2组合并症分别是30例(42.3%)和18例(41.9%)。结论:胎膜早破患者应在严密监护下尽可能的延长孕龄。PPROM不增加早产儿感染率,分娩方式与早产儿预后无关。无医学指征不行剖宫产术。

Objective: To discuss the management of preterm premature rupture on membrances (PPROM) and prognosis of premature, and improve the survival quality of premature. Methods: Premature cases were randomly divided into PPROM and non PPROM groups. Protective treatments were taken in 2 groups. Pregnant week, weight and survival states of premature were compared. Results: The incidence were 8.3% and 8.5%, the average pregnant week were 34.5 weeks and 34.3 weeks, and premature delivery were 61 cases (56%) and 41 cases (36.6%) in PPROM and non PPROM groups respectively. There was a significant difference between the two groups (P < 0.01). The complications were 48 cases (42.1%) and 49 cases (40.5%) in two groups respectively. Delivery in 48 hours of PROM were 71 cases, the pregnant week was 34.8 weeks, and weight was 2 435 g. Delivery after 48 hours of PPROM were 41 cases, the pregnant week was 33.7 weeks, and weight was 2 063 g. Complications were 30 cases (42.3%) and 18 cases (41.9%) in two groups respectively. Conclusion: Gestational week should be prolonged as long as possible under wardship in patients with PPROM. PPROM does not increase the infection rate of premature and there is no relation between delivery method and prognosis. Caesarean section can not be conducted without indication.