盐酸氨溴索结合维生素A对未足月胎膜早破促胎肺成熟的效果

目的探讨产前应用盐酸氨溴索结合口服维生素A对未足月胎膜早破患者促胎肺成熟的效果。方法选择2009～2011年我院住院的58例未足月胎膜早破的孕妇,按胎龄配对分为观察组和对照组各29例,均按期待疗法原则做基础治疗,促胎肺成熟药观察组用静脉盐酸氨溴索30 mg/次,每天两次,连续4天;同时口服维生素A 4 000 IU/天直至分娩。对照组用地塞米松。观察新生儿死亡、新生儿呼吸窘迫综合征发病率,分娩时测定羊水板层小体数值判定胎儿肺成熟度,所有数据进行统计学分析。结果观察组发生新生儿呼吸窘迫综合征3例(9.38%),对照组发生6例(20.69%),差异有统计学意义(p<0.05)。观察组早产儿死亡2例(6.89%),对照组4例(13.79%),差异有统计学意义。在羊水板层小体数值≤15×103/μl的区间观察组7例(24.14%),对照组11例(37.93%),差异有统计学意义(p<0.05);结论产前应用盐酸氨溴索结合维生素A可以明显提高胎儿肺成熟度,降低新生儿呼吸窘迫综合征发病率和早产儿死亡率。

THE EFFECT OF AMBROXOL HYDROCHLORIDE COMBINED WITH VITAMIN A TO PRO- MOTE FETAL LUNG MATURITY ON THE PPRM

Objective To research the effect of antenatal ambroxol hydrochloride combined with oral vitamin A to promote fetal lung maturity on the preterm premature rupture of the membrane in antenatal. Methods 58 cases of preterm premature rupture of membranes, in 2009 - 2010, according to gestational age partnership, were divided into observation group and control group with 29 cases in each group. In term of the expectant treatment principle, foundation treatment was given to both groups. The observation grouo, for improving the fetal lung maturity, were giv-en prenatal and intravenous ambroxol hydrochloride 30 mg, two times a day, for 4 days ; at the same time, Vitamin A 4 000 IU orally every day until delivery. 36cases in the control group Dex 6mg, two times a day, for 4 days. Observe neonatal death and neonatal respiratory distress syndrome incidence. During delivery the amniotic fluid lamellar body used to determine fetal lung maturity. All data were statistically analyzed. Results In the observation group neonatal respiratory distress syndrome occurred in 3 cases （9. 38% ）, in the control group 9 cases （28.13%）, the difference was statistically significant （p 〈 0. 01 ） ; in the observation group 2 cases premature death and 4 cases in the control group, the difference was statistically significant （p 〈 0. 05）. In the amniotic fluid lamellar body is≤15×10^3/μL, in 7 cases of observation group（24. 14% ）, 11 cases of the control group（37.93% ）, the difference was statistically significant （p 〈 0. 05）. Conclusion Antenatal ambroxol hydrochloride combined with VA can significantly improve the fetal lung maturity, reduce neonatal respiratory distress syndrome morbidity and premature mortality.