妊娠期糖尿病患者应用沐舒坦和地塞米松预防新生儿呼吸窘迫综合征的对比研究

Comparative study on application of ambroxol and dexamethasone in patients with gestational diabetes prevention of neonatal respiratory distress syndrome

目的探讨妊娠期糖尿病患者使用沐舒坦和地塞米松预防新生儿呼吸窘迫综合征的临床效果。方法将2014年1月~2015年7月我院收治的妊娠期糖尿病并发早产孕妇（150例）随机分为三组,分别给予沐舒坦静脉滴注（沐舒坦治疗组50例）、地塞米松静脉滴注（地塞米松治疗组50例）以及不治疗（对照组50例）,对比三组患者中早产儿呼吸窘迫综合征的发生率,统计三组患者的宫内感染率、新生儿感染率、孕妇血糖升高情况等指标。结果沐舒坦组早产儿呼吸窘迫综合征发生率为3.3%,地塞米松组10.0%,对照组24.0%,沐舒坦组早产儿呼吸窘迫综合征发生率低于地塞米松组,地塞米松组早产儿呼吸窘迫综合征发生率低于对照组,差异均有统计学意义（P〈0.05）。沐舒坦组宫内感染率及新生儿感染率均低于地塞米松组,同时地塞米松组宫内感染率及新生儿感染率均低于对照组,差异均有统计学意义（P〈0.05）。沐舒坦组与对照组相比用药后空腹血糖水平、餐后2 h血糖水平差异均无统计学意义（P〉0.05）,而地塞米松组与对照组相比用药后2 h血糖水平明显升高,差异有统计学意义（P〈0.05）。结论沐舒坦能有效降低妊娠期糖尿病孕妇的新生儿呼吸窘迫综合征发生率,同时降低产妇宫内感染及新生儿感染率,患者血糖指标未受到较大影响,值得临床推广。

Objective To explore clinical effects of application of ambroxol and dexamethasone in patients with gestational diabetes prevention of neonatal respiratory distress syndrome.Methods Gestational diabetes complicated with premature labor（150 cases） treated in our hospital from January 2014 to July 2015 were randomly divided into 3 groups and given ambroxol intravenous injection（mucosolvan treatment group 50 cases）,dexamethasone intravenous injection（dexamethasone treatment group 50 cases） and no treatment（control group 50 cases）,incidence of patients with premature neonatal with respiratory distress syndrome among three groups was compared,intrauterine infection rate,neonatal infection rates,elevated maternal blood glucose and other indicators of patients in three groups were counted.Results Incidence rate of premature infants with neonatal respiratory distress syndrome was 3.3% in ambroxol treatment group,with 10.0% in dexamethasone treatment group,with 24.0% in control group,the incidence of premature infants with neonatal respiratory distress syndrome in ambroxol treatment group lower less than that in dexamethasone treatment group,and the incidence in dexamethasone treatment group was lower than that in the control group,the difference both were significant（P〈0.05）.The rate of intrauterine infection and neonatal infection rate in ambroxol treatment group were lower than those in dexamethasone treatment group,with significant difference（P〈0.05）;at the same time,the rate of intrauterine infection and neonatal infection rate in dexamethasone treatment group were less than those in control group,and the difference was significant（P 〈0.05）.Ambroxol treatment group compared with control group,after medication fasting blood glucose level and postprandial 2 h blood glucose level had no significant difference（P〉0.05）,and dexamethasone treatment group compared with control group,after medication postprandial 2 h blood glucose level was significantly elevated,the difference was significant（P〈0.05）.Conclusion Ambroxol can effectively reduce incidence of gestational diabetes patients with neonatal respiratory distress syndrome,and reduce maternal intrauterine infection rate and neonatal infection rate,blood glucose level has not been affected,which is worthy of clinical promotion.