倍他米松联合硫酸镁治疗未足月胎膜早破的疗效观察

Efficacy of Betamethasone Combined with Magnesium Sulfate on Preterm Premature Rupture ofMembranes

目的:探讨未足月胎膜早破的有效治疗方案。方法:选取我院收治的120例未足月胎膜早破孕妇[入院孕周28~34(33.47±3.19)周],按治疗方案分为对照组和研究组各60例。对照组给予倍他米松治疗(肌肉注射12 mg),研究组给予倍他米松联合硫酸镁治疗,2 d后评估各项指标。比较两组孕妇炎症因子(IL-2、TNF-α)水平、持续治疗时间、孕周延长时间、宫缩抑制时间、产后出血量、焦虑情况、分娩结局[Apgar评分、新生儿出生体质量、产褥感染发生率及新生儿呼吸窘迫综合征(NRDS)发生率]、新生儿肺功能及不良反应发生率。结果:治疗后两组孕妇血清IL-2、TNF-α水平均降低,且研究组均低于对照组(P均<0.01);研究组持续治疗时间、宫缩抑制时间均短于对照组,孕周延长时间长于对照组(P均<0.05);研究组Apgar评分、新生儿出生体质量均高于对照组,NRDS、出生窒息发生率均低于对照组(P均<0.05);研究组新生儿出生第1天、第7天气道阻力低于对照组,功能残气量和肺顺应性高于对照组(P均<0.01)。结论:倍他米松联合硫酸镁治疗未足月胎膜早破,可有效降低炎症反应及NRDS发生率,缩短治疗时间,改善分娩结局及肺功能,且不增加不良反应发生率。

Objective:To explore the effective treatment of preterm premature rupture of membranes.Methods:A total of 120 preterm pregnant women with premature rupture of membranes with gestational weeks from 28 to 34(33.47±3.19)weeks admitted into our hospital were extracted to be divided into the control group and study group according to different treatment regimens,with 60 cases in each group.The control group was treated with betamethasone(12 mg intramuscular injection),while the study group received betamethasone combined with magnesium sulfate,all indicators were evaluated after 2 d.Levels of inflammatory factors(IL-2 and TNF-α),continuous treatment duration,prolonged gestational weeks,uterine contraction inhibition time,postpartum hemorrhage,anxiety,delivery outcome such as Apgar score,birth weight of neonates,incidence of puerperal infection and incidence of neonatal respiratory distress syndrome(NRDS),neonatal lung function,incidence of adverse drug reactions were compared between two groups.Results:After treatment,serum levels of IL-2 and TNF-αin both groups decreased,and the study group was lower than the control group(P<0.01).The treatment duration and uterine contraction inhibition time in the study group were shorter than those in the control group,and the prolonged gestational weeks was longer than those in the control group(P<0.05).The Apgar score and birth weight of neonates in the study group were higher than those in the control group,and the incidences of NRDS and neonatal asphyxia in the study group were lower than those in the control group(P<0.05).On the 1 st and 7 th day of birth,the airway resistance in the study group was significantly lower than that in the control group,the functional residual capacityand and lung compliance were significantly higher than those in the control group(P<0.01).Conclusion:Betamethasone combined with magnesium sulfate in the treatment of patients with preterm premature rupture of membranes can effectively reduce inflammation and incidence of NRDS,shorten treatment duration,improve delivery outcomes and lung function without increasing the incidence of adverse drug reactions.