1998～1999年成都市早产现状调查分析

目的　了解成都市的早产发病与诊治现状。方法　分析成都市 7家医院产科 1998～ 1999年收治的早产病例 10 2 4例。结果　早产的发生率为 4 9%。其中胎膜早破、妊娠胆汁瘀积症和前置胎盘占有重要比例 (分别为 3 1 6%、16 6%和 15 5 % ) ;先兆早产不伴有宫颈改变的孕妇较有宫颈改变者治疗延长孕龄 3天 2 0h(P <0 0 5 ) ,无阴道排液孕妇较有阴道排液者治疗痊愈率明显升高 (P <0 0 5 ) ;安宝治疗早产平均延长孕龄 7天 2h ,硫酸镁加沙丁胺醇较单独使用硫酸镁多延长 2天 ( 4天 18h∶2天 16h) (P <0 0 5 )。早产儿死亡占病例总数的 6 3 % ,新生儿呼吸窘迫综合征 ( 2 0 % )是早产儿死亡的主要原因 ,吸入性肺炎 ( 3 7% )是早产儿主要的并发症 ;NRDS的发生率在 <3 4周组 ( 8 9% )明显高于≥ 3 4周组( 0 3 6% ) (P <0 0 1) ;>3 0岁分娩的孕妇与 2 0～ 2 9岁孕妇比较 :其自然流产史、剖宫产比例、发生妊娠剧吐、前置胎盘、胎膜早破等均显著性增高 ,需要的治疗时间相对延长 (P <0 0 5 )。结论　筛查早产的危险因素 ,加强产前检查 ,早期发现、早期干预先兆早产 ,降低 3 4周以前的早产是降低早产及围生儿病死率的关键因素。

The analysis and investigation of premature delivery in Chengdu from 1998 to 1999

Objective To analysis the diagnosis and treatment of premature delivery in Chengdu.Methods 1024 cases of premature delivery from the department of Obstetric of seven hospitals in Chengdu were retrospective analyzed.Results The incidence of premature delivery was 4.9%.premature rupture of membrane,intrahepatic cholestasis of pregnancy and placenta previa were highly proportion (31.6%,16.6% and 15.5%);the prolonged gestation time of the pregnancy without cervical canal effacement and dilatation was more 3 days 20 hours than the one with that (P<0.05).The cure ratio in the pregnancy without vaginal discharge was higher than the one with that.The mean prolonged gestation period was 7 days 2 hours with tretment of ritodrine,While the treatment time of magnesium sulfate added salbutamol sulfate than magnesium sulfate were more 2 days (4 days 18 hours vs 2 days 16 hours)(P<0.05).The mortality rate of neonatal was 6.3%.Neonatal respiratory distress syndrome (2.0%) was major reason for premature neonatal death,and aspiration pneumonia (3.7%)was a major complication.The incidence of NRDS in less than 34 gestation weeks was rather higher than in over 34 weeks.It was much higher in the gravid age 30 than 20 to 29 in natural abortion history,the ratio of cesarean,hyperemesis gravidarum,placenta previa and premature rupture of membrane.Furthermore,the treatment time was prolonged (P<0.05).Conclusion Screening the risk factor of preterm labor,augmenting antenatal care,early discovering and early intervening threatened premature labor,reducing premature delivery before 34 weeks were critical factor to reduce the incidence of premature delivery and perinatal mortality.