≤孕34周胎膜早破早产儿的预后分析

Prognostic analysis of preterm premature rupture of membranes at≤34 pregnancy weeks

目的探讨有利于改善≤孕34周胎膜早破早产儿预后的措施。方法抽取笔者所在医院2001年1月至2007年2月住院分娩的72例≤孕34周胎膜早破早产儿,以产前使用地塞米松是否足4次将早产儿分为观察组及治疗组,比较两组间早产儿NRDS、HIE、新生儿窒息发生率;以是否进行早期干预将早产儿分为早期干预组与对照组,比较两组间身高、体重,DQ评分。结果治疗组的NRDS、HIE及新生儿窒息率均低于观察组(P<0.05),早期干预组的早产儿预后明显优于对照组(P<0.01),而两组间身长、体重等一般发育状况无显著性意义(P>0.05)。结论当≤孕34周胎膜早破早产时,尽可能足量使用地塞米松,可有效降低早产儿NRDS、HIE及新生儿窒息的发生率,提高存活率。对早产儿进行系统的早期干预,可明显改善早产儿预后,降低伤残率。

Objective To investigate the measures to improve the prognosis of preterm premature rupture of membranes（PPROM） at ≤34 pregnancy weeks infants. Methods 72 infants of PPROM at ≤34 pregnancy weeks between Jan 2001 and Dec 2007 in our hospital were included and divided into two groups：control group and the treatment group by whether prenatal use of DXM ≥4 times. The incidence of NRDS, HIE and neonatal asphyxia were compared. According to whether early - intervention was used on the infants or not, they were divided into two groups ： early - intervention group and observtion group. Weight and DQ score of premature infants were compared. Results The incidence of NRDS, HIE and neonatal asphyxia of the treatment group were significantly lower than the control group（ P〈0.05）, the prognosis of the early - inter- vention group was much better than the observtion group（P 〈 0.01）, but the height and weight between two groups had no difference（ P 〉 0.05）. Conclusion When infants ≤34 pregnancy weeks have PROM, sufficient DXM should be used, to reduce the incidence of NRDS, HIE and neonatal asphyxia. It will also obviously improve the prognosis of premature infants and decrease disabled rate by systematic early-intervention.