试述临床促早产儿肺成熟的皮质激素合理使用

由于早产儿各器官发育不成熟,其病死率和后遗症较足月儿显著增高,其中呼吸窘迫综合征(RDS)是导致早产儿死亡的最主要原因。皮质激素能刺激肺上皮细胞分化成Ⅱ型细胞,启动肺表面物质产生,降低新生儿RDS的发生,临床最常用的是地塞米松和倍他米松。对于孕24~34周有早产风险的孕妇合理规范的使用皮质激素促胎肺成熟,能显著降低RDS的发生率,有效改善早产儿预后,建议首选倍他米松12mg肌肉注射,每日2次,共2d,用药后24h至7d内分娩者效果最佳,超过7d未分娩者仍有早产风险者可在首次用药2周后重复用药1次。

Application of Adrenocortical Hormone in Stimulation of the Fetal Lung Maturity in Preterm Labor

Preterm labor leads to the infants delivered with immature body, who have an increased risk of mortality and morbidity. Respiratory distress（RDS） was regarded to be the greatest risk factor resulting in the preterm infant＇s death. Adenecortical hormone is able to stimulate the differentiation of type Ⅱ alveolar epithelium, which pmmote the production of surfaeo-active phespholipid to decrease the risk of KDS in the fetus. Dexamethasore and betamethasone are the two drugs used in clinical practice. Rationalization and standarlization of steroid drugs usage are thought to stimulate lung maturity and decrease the risk of RDS in the fetus born between 28 and 34 weeks of gestation, which will promote the neonatal outcome in the end. Betamethasone is usually favored. The routine dose is 12mg through intramuscular injection twice in one day.The full effect on maturing the surfactant has been obtained from 24 hours to 7day following the first dose. If the patient dose not deliver within 1 week, the treatment should be repeated.