目的探讨盐酸利托君与硫酸镁治疗先兆早产的效果,并分析效果与Creasy高危因素评分的关系,为临床指导用药提供参考。方法将广州市番禺区何贤纪念医院2013年2月~2014年2月收治的106例诊断为先兆早产患者按单双号原则分为研究组与对照组,...目的探讨盐酸利托君与硫酸镁治疗先兆早产的效果,并分析效果与Creasy高危因素评分的关系,为临床指导用药提供参考。方法将广州市番禺区何贤纪念医院2013年2月~2014年2月收治的106例诊断为先兆早产患者按单双号原则分为研究组与对照组,每组各53例。研究组采用盐酸利托君治疗,对照组患者给予硫酸镁治疗。对两组药物起效时间、延长妊娠时间、妊娠结局、新生儿一般情况和药物不良反应情况进行记录。根据两组患者保胎效果再行Creasy高危因素评分,比较两组保胎成功者Creasy≥12分的患者比率。结果治疗后研究组药物起效时间明显加快,且延长妊娠时间明显增长(P<0.05)。研究组保胎成功率显著高于对照组(96.23%比83.02%)(P<0.05)。研究组新生儿出生体重和1 min Apgar评分均优于对照组(P<0.05)。且研究组的不良反应发生率明显低于对照组(3.77%比15.09%)(P<0.05)。两组保胎成功者Creasy高危因素评分均明显低于保胎失败者(P<0.05)。研究组Creasy高危因素评分≥12分患者比率高于对照组(26.42%比15.09%)(P<0.05)。结论盐酸利托君治疗先兆早产临床效果优于硫酸镁,药物起效时间快,对于延长患者孕龄、提高新生婴儿的存活率方面效果显著,且不良反应较轻微。Creasy高危因素评分对先兆早产的妊娠结局具有重要影响,对Creasy高危评分≥12分的先兆早产患者,应优先考虑使用盐酸利托君治疗。展开更多
Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gyneco...Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.展开更多
文摘目的探讨盐酸利托君与硫酸镁治疗先兆早产的效果,并分析效果与Creasy高危因素评分的关系,为临床指导用药提供参考。方法将广州市番禺区何贤纪念医院2013年2月~2014年2月收治的106例诊断为先兆早产患者按单双号原则分为研究组与对照组,每组各53例。研究组采用盐酸利托君治疗,对照组患者给予硫酸镁治疗。对两组药物起效时间、延长妊娠时间、妊娠结局、新生儿一般情况和药物不良反应情况进行记录。根据两组患者保胎效果再行Creasy高危因素评分,比较两组保胎成功者Creasy≥12分的患者比率。结果治疗后研究组药物起效时间明显加快,且延长妊娠时间明显增长(P<0.05)。研究组保胎成功率显著高于对照组(96.23%比83.02%)(P<0.05)。研究组新生儿出生体重和1 min Apgar评分均优于对照组(P<0.05)。且研究组的不良反应发生率明显低于对照组(3.77%比15.09%)(P<0.05)。两组保胎成功者Creasy高危因素评分均明显低于保胎失败者(P<0.05)。研究组Creasy高危因素评分≥12分患者比率高于对照组(26.42%比15.09%)(P<0.05)。结论盐酸利托君治疗先兆早产临床效果优于硫酸镁,药物起效时间快,对于延长患者孕龄、提高新生婴儿的存活率方面效果显著,且不良反应较轻微。Creasy高危因素评分对先兆早产的妊娠结局具有重要影响,对Creasy高危评分≥12分的先兆早产患者,应优先考虑使用盐酸利托君治疗。
基金the National Key Research&Development Program of China(2016YFC1000400,2018YFC1002903).
文摘Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.
