林珏莹

【摘要】 目的 探究地塞米松對未足月胎膜早破孕妇妊娠结局的影响。方法 70例未足月胎膜早破孕妇， 随机分为对照组和观察组， 每组35例。对照组孕妇未使用地塞米松， 观察组孕妇实施地塞米松治疗。比较两组孕妇妊娠结局、新生儿预后情况、破膜至分娩时间及产程。结果 观察组孕妇脐带脱垂、产后出血、剖宫产、死产及新生儿死亡发生率均低于对照组， 差异具有统计学意义（P<0.05）。治疗后， 观察组新生儿Apgar评分为（8.06±3.44）分， 对照组新生儿Apgar评分为（5.16±3.57）分， 观察组新生儿Apgar评分高于对照组， 差异具有统计学意义（t=3.461， P<0.05）。观察组孕妇破膜至分娩时间及产程均短于对照组， 差异具有统计学意义（P<0.05）。结论 地塞米松治疗未足月胎膜早破孕妇能有效缩短破膜至分娩时间及产程， 提高产妇生产的安全性及新生儿的存活率， 并能有效减少新生儿不良情况的发生， 在临床应用中具有较高的推广价值。

【关键词】 地塞米松；未足月胎膜早破；妊娠结局

DOI：10.14163/j.cnki.11-5547/r.2017.17.059

Influence by dexamethasone on pregnancy outcome in pregnant women with preterm premature rupture of membranes LIN Jue-ying. Department of Obstetrics， Jieyang City Peoples Hospital， Jieyang 522000， China

【Abstract】 Objective To investigate influence by dexamethasone on pregnancy outcome in pregnant women with preterm premature rupture of membranes. Methods A total of 70 pregnant women with preterm premature rupture of membranes were randomly divided into control group and observation group， with 35 cases in each group. The control group did not receive dexamethasone， and the observation group received dexamethasone for treatment. Comparison was made on pregnancy outcome， neonatal prognosis， duration from rupture of membranes to delivery， and stages of labor between the two groups. Results The observation group had all lower incidence of prolapse of cord， postpartum hemorrhage， cesarean sec， stillbirth and perinatal mortality than the control group， and their difference had statistical significance （P<0.05）. After treatment， the observation group had neonatal Apgar score as （8.06±3.44） points， and the control group had neonatal Apgar score as （5.16±3.57） points. The observation group had higher neonatal Apgar score than the control group， and their difference had statistical significance （t=3.461， P<0.05）. The observation group had all shorter duration from rupture of membranes to delivery， and stages of labor than the control group， and the difference had statistical significance （P<0.05）. Conclusion In treating pregnant women with preterm premature rupture of membranes， dexamethasone can effectively shorten duration from rupture of membranes to delivery and stages of labor， improve safety for puerpera and survival rate of newborn， and decrease occurrence of neonatal adverse reactions. This method contains highly promoting value in clinical application.

【Key words】 Dexamethasone； Preterm premature rupture of membranes； Pregnancy outcome

胎膜早破是一种常见的产科并发症， 是指孕妇在临产前胎膜发生破裂[1]。胎膜早破对母体及新生儿的安全均可造成严重的影响。尤其是未足月胎膜早破（妊娠28～37周内发生胎膜早破）对母体及新生儿的危害更大[2]。临床调查显示， 未足月胎膜早破能使新生儿在围生期的发病率提高3倍、病死率提高4倍[3]。未足月胎膜早破的新生儿容易发生呼吸窘迫综合征、肺发育不全、脐带脱垂等并发症。因胎膜早破造成母体羊水过少， 可导致孕妇分娩时胎儿窘迫、脐带受压， 增加剖宫产率， 对新生儿的预后产生严重的影响[4]。因此， 科学有效的改善未足月胎膜早破情况是目前临床研究的热点。有学者认为， 给予未足月胎膜早破孕妇适量的地塞米松， 能有效改善孕妇妊娠结局[5]。基于此， 本研究选择2014年6月～

2015年11月本院收治的未足月胎膜早破孕妇70例为研究对象， 分析地塞米松对未足月胎膜早破孕妇妊娠结局的影响。现报告如下。

1 资料与方法