产前联合应用地塞米松与维生素K_1预防早产儿脑室周围-脑室内出血的效果

Effect of Antenatal Administration of Dexamethasone and Vitamin K_1 for Prevention of Periventricular-Intraventricular Hemorrhage in Premature Infant

目的探讨产前联合应用地塞米松（DEX）＋VitK1预防早产儿脑室周围-脑室内出血（PIVH）的疗效。方法将264例胎龄〈35周早产儿随机分成3组：A组产前母亲应用DEX组133例，孕妇在分娩前静脉点滴DEX10mg／d，连用2d。B组产前母亲联合应用DEX与VitK1组（DEX＋VitK1组）44例：孕妇在分娩前静脉点滴DEX外，给予VitK1 10mg／d，连用2-7d。C组分娩前母亲未用DEX和VitK1为对照组，共87例。婴儿出生后常规作头颅超声，了解是否存在PIVH及其程度。结果3组早产儿PIVH发生率分别为DEX组52．6％，DEX＋VitK1组31．8％，对照组65．2％，3组间有显著差异（χ^2=13.469 P=0．001）；DEX＋VitK1组重度PIVH发生率显著降低。结论产前联合应用DEX与VitK1能够显著降低早产儿PIVH的发生率，并减轻其程度。

Objective To estimate the effect of antenatal administration of dexamethasone（DEX） and vitamin K1 （VitK1）for prevention of pefiventricular intraventricular hemorrhage （PIVH） in premature infant. Methods A total of 264 prematare infants were less than 35 weeks＇ gestational age were divided randomly into 3 groups. Group A： of 133 infants who received antenatal DEX 10mg per day for 2 days. Group B：of 44 infants who received antenatal DEX 10 mg pcr day for 2 days and VitK1 10 mg per day for 2- 7 days. Group C： of 87 infants who received antenatal neither DEX nor VitK1. Ultrasound was performed to understand if the neonates suffering from intracranial hemorrhage. Results The incidence of PIVH in preterm infants were respectively group A 52.0 %, group B 31.8 % and group C 65.2 %. There was significant difference among 3 groups（χ^2 = 11. 776 P = 0. 003）, Furthermore, antenatal using DEX and VitK1 significantly lowed the frequency of high grade hemorrhages. Conclusion Antenatal administration DEX and VitK1 can markedly reduce the incidence of PIVH and low the degree of hemorrhages in preterm infants.