地塞米松不同用药途径对初产孕妇剖宫产术后感染及神经根损伤的影响

Effect of dexamethasone on infection and nerve root injury after cesarean section in primipara with different routes of administration

目的本研究旨在探讨地塞米松不同用药途径对初产孕妇剖宫产患者术后C反应蛋白(CRP和白细胞计数(WBC)的影响,以及分析地塞米松能否降低产褥感染和神经根损伤症状的发生。方法选取2022年6月至2023年6月温州医科大学附属新昌医院90例初产孕妇剖宫产患者,根据是否给予地塞米松及给药途径进行分组,分为E组(硬膜外给药)、I组(静脉给药)、W组(未给药)。其中,E组在分娩断脐后2 min给予硬膜外注射地塞米松5 mg/2 ml,I组在分娩断脐后2 min给予静脉注射地塞米松5 mg/2 ml,W组则不给予地塞米松。记录术前、术后2 d、术后4 d的CRP和WBC,比较产褥感染和神经根损伤症状的发生情况。结果术后2 d,3组产妇的CRP差异均具有统计学意义(P<0.05);术后4 d,E组与I组、E组与W组的CRP差异具有统计学意义(P<0.05),而I组与W组的差异无统计学意义(P>0.05)。术后2 d,3组产妇WBC差异均无统计学意义(P>0.05);术后4 d,E组与I组、I组与W组的WBC差异无统计学意义(P>0.05),而E组与W组的差异具有统计学意义(P<0.05)。3组产妇在产褥感染方面差异有统计学意义(P<0.05),神经根损伤症状方面差异均无统计学意义(P>0.05)。结论相较于静脉给药,硬膜外给予地塞米松能够更有效地使初产孕妇行剖宫产患者术后异常升高的CRP和血清WBC趋向于正常水平。无论是硬膜外还是静脉给药,地塞米松均能降低产褥感染和神经根损伤症状的发生率。

Objective To investigate the effects of different routes of dexamethasone administration on the C-reactive protein(CRP)and white blood cell count(WBC)in primiparous women after cesarean section,and to analyze whether dexamethasone can reduce puerperal infection and nerve root injury.Methods A total of 90 primiparous women who underwent cesarean section in Xinchang Hospital from June 2022 to June 2023 were selected and grouped according to whether dexamethasone was administered and the route of administration based on the random number table method.All patients were divided into Group E(epidural administration),Group I(intravenous administration),and Group W(no administration).Group E received epidural injection of dexametha-sone 5 mg/2 ml two minutes after delivery of the umbilical cord,Group I received intravenous injection of dexamethasone 5 mg/2 ml two minutes after delivery of the umbilical cord,and Group W did not receive dexamethasone.The CRP and WBC of each group were recorded and compared before surgery,2 days after surgery,and 4 days after surgery.The occurrence of puerperal infection and nerve root injury symptoms in each group were also ob-served.Results Two days after surgery,the differences in CRP among the three groups of parturients were statistically significant(P<0.05).Four days after surgery,the differences in CRP between Group E and Group I,as well as between Group E and Group W,were statistically significant(P<0.05),while the difference in CRP between Group I and Group W was not statistically significant(P>0.05).Two days after surgery,there were no statistically significant differences in WBC among the three groups of parturients(P>0.05).Four days after surgery,there were no statistically significant differences in WBC between Group E and Group I,as well as between Group I and Group W(P>0.05),while the difference between Group E and Group W was statistically significant(P<0.05).There were statistically significant differences in puerperal infection among the three groups of parturients(P<0.05),while there were no statistically significant differences in nerve root injury symptoms(P>0.05).Conclusion Compared with intravenous administration,epidural administration of dexamethasone can more effectively normalize the abnormally elevated CRP and WBC in primiparous women after cesarean section.Both epidural and intravenous administration of dexamethasone can reduce the incidence of puerperal infection and nerve root injury symptoms.