早产并胎膜早破110例临床观察

Clinical obserration of premature labor complicated with premature rupture of membranes in 110 cases

目的探讨早产并胎膜早破的正确处理及并发症的防治。方法 110例患者,均按早破膜常规处理,除50例难免早产仅给氟美松10 mg肌注,每日2次,其剩下的60例均给予口服舒喘灵4．8 mg每6小时1次,静滴25％硫酸镁30-60 ml/d,地塞米松10 mg肌注,2次/d,同时注意监测体温、白细胞计数、胎心和羊水性状。结果保胎成功49例,失败11例,<34周分娩者围生儿病死率显著高于≥34周者,差异有显著意义(P<0．01),而<36周新生儿窒息率与近足月组相比差异有显著意义(P<0．05),<34周者呼吸窘迫综合征(RDS)明显增加,超过34周围生儿存活率有明显改善。结论宫缩抑制剂、地塞米松、预防感染药物正确应用,适时终止妊娠,是正确处理早产并胎膜早破的最佳措施。

Objective To study the clincal characters of premature labor compicated with premature rupter of membrance,and how to prevent and treat the complications. Methods Among the 110 cases, according to the nursing routine treatment, we treat 50 of them with 10mg im bid. The rest are treated with 4.8mg q6h of oral .salbutamoulum,30--60ml of intravenous drip of 25 % of magnesii sulfas per day. 10mg of muscle injection of dexamethasoni acetas. Mean while, observe body temperature, the number of white blood cells, the foetus heartbeat and the shape and property of amniotic fluid. Results The 49 cases are successful, 11 of which failure. The death rate of less than 34 weeks is much higher than that of more than 34 weeks. The difference is rery obvious（ P 〈 0.01 ）. Compared with the mature baby, the choking death, rate of less than 36 weeks is much higher（ P 〈 0.05 ）. The babies of less than 34 weeks suffer more from breathing with difficalty the living birthrate of more than 34 weeks in creased greatly. Conclusion The correct use of depressor of uterine contraition,dexamethasoni acetas and the medicine to prevent from beins infected and stopping gestation at proper time are best measnres taken to deal with premature delivery and prerupture of foetal membrane.