286例胎膜早破性早产新生儿结局的临床分析

The Clinical Analysis of the Neonatal Outcome of 286 Cases of Preterm Premature Rupture of the Membranes

目的：了解产前糖皮质激素干预对胎膜早破性早产新生儿结局的影响。方法：对我院286例胎膜早破性早产病例的临床资料进行回顾性分析。结果：34～35^＋6周孕龄组新生儿1分钟Apgar评分〈7分的发生率、窒息率及新生儿呼吸窘迫综合征（NRDS）发生率在干预组明显低于对照组，两组间比较差异有显著性（P〈0、05）。36～36^＋6周孕龄组新生儿窒息率、缺血缺氧性脑痛（HIE）发生率、NRDS发生率及其他并发症发生率在干预组明显低于对照组，两组间比较差异有显著性（P〈0．05）。28～31^＋6周及32～33^＋6周孕龄组新生儿结局的各项指标在干预组与对照组间比较差异无显著性（P〉0．05）。结论：34～36^＋6孕周胎膜早破性早产孕妇产前使用糖皮质激素干预能显著改善新生儿结局。因样本量关系，〈34孕周的胎膜早破性早产孕妇产前使用糖皮质激素干预对新生儿结局有无明显改善还有待于进一步探讨。

Objective： To understand the impact of antenatal treatment with corticosteroid on the neonatal outcome of preterm premature rupture of the membranes. Methods： The clinical data of 286 cases of preterm labor with PROM were analyzed retrospectively. Among them, 199 cases with different gestational age were treated by Dexamethasone before labor as treatment group, and other 87 cases as control group without any antenatal treatment. Results： The incidence of neonatal Apgar score in one minute 〈 7, asphyxia and NRDS in the treatment group was significantly lower than in the control group in 34-35^＋6 gestational age（P〈0.05）. The incidence of neonatal asphyxia,HIE, NRDS and other complications in the treatment group was significantly lower than in the control group in 36-36^＋6 gestational age（P〈O.05）. All index about the neonatal outcome had no significant difference between 28-31^＋6 and 32-33^＋6 gestational age（P〉0.05）. Conclusions： Antenatal treatment with corticosteroid could improve the neonatal outcome of premature rupture of the membranes within 34-36^＋6 gestational ages. However, its effect on preterm neonatal of gestational week less than 34 is uncertain because of the limited number of cases.