早期足月妊娠择期剖宫产术前糖皮质激素使用对预防新生儿呼吸窘迫综合征发生的影响

Influence of glucocorticoid use before elective cesarean section on prevention of neonatal respiratory distress syndrome in early term pregnancy

目的:分析早期足月妊娠择期剖宫产术前使用糖皮质激素对预防新生儿呼吸窘迫综合征(NRDS)的影响。方法:2018年5月-2019年10月收治早期足月妊娠择期剖宫产产妇200例,双盲随机抽样法分为两组,各100例。试验组术前给予地塞米松肌内注射;对照组不给予地塞米松。比较两组临床效果。结果:试验组新生儿1 min、5 min Apgar's评分均明显高于对照组,差异有统计学意义(P<0.05);试验组新生儿出生即刻、出生24 h后SpO_(2)、PaO_(2)水平均明显高于对照组,PaCO_(2)、RR、HR水平均明显低于对照组,差异有统计学意义(P<0.05);试验组NRDS发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:早期足月妊娠择期剖宫产术前给予糖皮质激素,可有效降低呼吸频率及心率,改善动脉血气指标水平,降低NRDS发生率。

Objective:To explore the influence of glucocorticoid use before elective cesarean section on prevention of neonatal respiratory distress syndrome(NRDS)in early term pregnancy.Methods:From May 2018 to October 2019,200 pregnant women with elective cesarean section in early term pregnancy were selected and randomly divided into two groups with 100 cases in each group with double blind random sampling.The experimental group was given dexamethasone intramuscular injection before operation.The control group was not given dexamethasone.We compared the clinical effects of the two groups.Results:In the experimental group,the Apgar's scores at 1 minute and 5 minutes were significantly higher than those in the control group,the difference was statistically significant(P<0.05).In the experimental group,at immediately after birth and 24 hours after birth,SpO_(2) and PaO_(2) levels were significantly higher than those in the control group,while PaCO_(2),RR and HR levels were significantly lower than those in the control group,the difference was statistically significant(P<0.05).In the experimental group,the incidence of NRDS was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Glucocorticoid use before elective cesarean section in early term pregnancy can effectively reduce respiratory rate and heart rate,improve arterial blood gas index level and reduce the incidence of NRDS.