早产儿胎膜早破与呼吸窘迫综合征

Preterm Rupture of Fetal Membranes and Neonatal Respiratory Distress Syndrome in Premature Infants

目的探讨胎膜早破对早产儿呼吸窘迫综合征(RDS)发生的影响。方法回顾性分析1997-2000年在我院分娩、胎龄为27-33周的早产儿。依据产妇胎膜早破是否超过24 h,将早产儿分为胎膜早破组44例与对照组99例。采用t检验、x2 检验及Fisher确切概率计算法分析数据。结果两组胎龄分别为(32.30±1.31)、(31.9±1.7)周,出生体质量分别为(1834±378)g、(1838±431)g。两组破膜至胎儿娩出时间分别为(111.9±124.6)、(3.4±6.0)h,经统计分析有显著差异(P<0.001)。胎膜早破组RDS发生率显著低于对照组(P<0.05)。胎膜早破组孕产妇官腔内感染率与新生儿败血症发生率较对照组高,但无显著差异。结论对于<33周的早产儿,胎膜早破超过24 h可能促进胎肺成熟,进而显著降低RDS发生。

Objective To study the influence of preterm rupture of the fetal membranes on the frequency of necnatal respiratory distress syndrome. Methods Retrospective analysis was performed on preterm infants delivered between 27 and 33 weeks of gestation. Patients were categorized into 2 groups according to whether the length of preterm rupture of the fetal membrane was over 24 hours： preterm rupture group（ 〉24 hours） and versus control group（ 〈24 hours）. Data were analyzed with t test, chi - square test, and the Fisher exact test. Results A total of 143 patients included 44 patients in premature rupture group and 99 patients in control group. Patients were delivered at （32.3 ± 1.31 ） and （31.9 ±1.7） weeks of gestation, with birth weight of （ 1834 ± 378） g and （ 1838 ± 431 ） g respectively. The frequency of neonatal respiratory distrss syndrome significant lower in the premature rupture group than that in control group （0 % and 11.1% P 〈 0.05 ）. Intrauterine infection rate and the incidence of neonatal septicemia were higher in the premature rupture group than that in control group, but there was no statistical significance. Conclusions In the present clinical .setting of delivery between 27 - 33 weeks of gestation, premature rupture of the membrane over 24 hours may improve the development of fetal membrane,which is significantly as,sociated with the decline in the frequency of neonatal respiratory distrss syndrome.