糖皮质激素产前肌注用于早产儿效果探讨

目的：探讨糖皮质激素产前肌注对早产儿产后并发症、远期生长及智力发育水平的影响。方法研究对象选取四川乐山市人民医院妇产科2012年7月至2014年7月收治早产分娩产妇共120例,其中64例仅行硫酸镁产前静脉滴注,设为对照组,56例则在此基础上加用糖皮质激素产前肌注,设为观察组;比较两组早产儿Apgar评分、呼吸窘迫综合征发生率、死亡率、随访1年生长发育指标及智力发育指标水平等。结果两组早产儿产后1min Apgar评分比较无显著性差异（t＝1．34,P＞0．05）,观察组早产儿产后5min Apgar评分显著高于对照组,差异具有统计学意义（t＝2．04,P＜0．05）。观察组早产儿呼吸窘迫综合征发生率和死亡率均显著低于对照组,差异具有统计学意义（χ2值分别为4．94、2．02,均P＜0．05）。两组早产儿生长发育指标水平和智力发育指标水平比较均无显著性差异（t值分别为1．54、1．21、1．10、1．34、1．62、1．47、1．36、1．55,均P＞0．05）。结论糖皮质激素产前肌注可有效降低早产儿呼吸窘迫综合征发生和死亡风险,且对远期生长及智力发育水平无不利影响。

Clinical effects of prenatal glucocorticoid by intramuscular injection on preterm infants

Objective To investigate the effects of prenatal glucocorticoid by intramuscular injection on postpartum complications and long -term growth and mental development of preterm infants .Methods From July 2012 to July 2014 totally 120 patients with premature delivery admitted in department of obstetrics and gynecology in People ’ s Hospital of Leshan City were selected as research objects , and 64 cases in control group with prenatal magnesium sulfate by intravenous infusion and 56 cases in observation group with prenatal glucocorticoid by intramuscular injection additionally .Apgar score, incidence of respiratory distress syndrome , mortality, growth development indicators and mental development indicators in 1 year of follow-up were compared between groups .Results There was no significant difference in 1min Apgar score between two groups (t=1.34, P>0.05).The 5 min Apgar score of the observation group was higher than the control group , and the differences was statistically significant (t=2.04, P<0.05).The incidence of respiratory distress syndrome and mortality of the observation group were significantly lower than the control group (χ2 value was 4.94 and 2.02, respectively, both P<0.05).There were no significant differences in the level of growth and development indexes and intelligence development index between two groups ( t value was 1.54, 1.21, 1.10, 1.34, 1.62, 1.47, 1.36 and 1.55, respectively, all P >0.05).Conclusion Prenatal glucocorticoid by intramuscular injection on premature infant can efficiently reduce the risk of respiratory distress syndrome and death and has no adverse effect on long-term growth and intellectual development .