术前肌注地塞米松在早产促胎肺成熟中的疗效观察

Observation on the Efficacy of Preoperative Intramuscular Injection of Dexamethasone in Acceleration of Lung Maturation of Preterm Labor

目的探讨术前肌注地塞米松在早产促胎肺成熟中的疗效。方法回顾性分析我院胎龄为28～34周单胎早产的110例产妇的临床资料,根据产前使用地塞米松情况分为使用地塞米松组(观察组, n=59)和未使用地塞米松组(对照组, n=51)。比较两组早产儿的1 min及5 min阿氏评分(Apgar评分)、出生12 h血气分析指标、呼吸窘迫综合征(RDS)发生率及严重程度,并记录两组产妇的产褥感染发生情况。结果两组早产儿的5 min Apgar评分均较1 min Apgar评分高(P <0.05),且观察组早产儿的1 min及5 min Apgar评分均显著高于对照组(P <0.05)。观察组早产儿出生12 h时的血气分析指标(pH、 PaO2、PaCO2水平)均显著高于对照组(P <0.05),而RDS发生率及严重程度均显著低于对照组(P <0.05)。两组产妇的产褥感染发生率比较,差异无统计学意义(P>0.05)。结论产前使用地塞米松可缓解早产儿出生后的缺氧情况,减少RDS的发生,改善早产儿动脉血气指标,有利于早产儿的生长发育,且对产妇产褥感染无不良影响。

Objective To explore the efficacy of preoperative intramuscular injection of dexamethasone in acceleration of lung maturation of preterm labor. Methods The clinical data of 110 cases of parturients with single fetal preterm birth at 28 ~ 34 gestational age were analyzed retrospectively. According to the prenatal use of dexamethasone, they were divided into dexamethasone group (observation group, n = 59) and non-dexamethasone group (control group, n = 51). The 1 min and 5 min Apgar scores, blood gas analysis indicators at 12 h after birth, and incidence rate and severity of respiratory distress syndrome (RDS) were compared between preterm infants of the two groups, and the occurrences of puerperal infection of parturients in the two groups were recorded. Results Both groups had significantly higher 5 min Apgar score than 1 min Apgar score (P <0.05), and the 1 min and 5 min Apgar scores of preterm infants in observation group were higher than those in control group (P <0.05). The levels of blood gas analysis indicators (pH, PaO2 and PaCO2) of preterm infants at 12 h after birth in observation group were higher than those in control group (P <0.05), and the incidence rate and severity of RDS were lower than those in control group (P <0.05). No significant difference was found in the incidence rate of puerperal infection between the two groups (P >0.05). Conclusions Preoperative intramuscular injection of dexamethasone has a significant application effect in acceleration of lung maturation, which can improve hypoxic conditions of preterm infants, increase pulmonary ventilation function, and reduce the incidence rate of RDS, which is beneficial to the growth and development of preterm infants, without adverse effects on maternal puerperal infection.