地塞米松促胎肺成熟的两种用药方式对糖耐量异常孕产妇及围生儿的影响

目的观察地塞米松促胎肺成熟用药方式对糖耐量异常孕产妇及围生儿的影响。方法将2005年6月至2006年6月我院40例糖耐量异常的孕产妇分为A组(肌注地塞米松组)和B组(羊膜腔注射地塞米松组)。观察用药前后血糖、尿酮体和胎心监护变化,以及两组新生儿窒息、高胆红素血症的发生情况。结果孕妇肌注地塞米松后3餐后2h血糖有明显升高,尿酮体于晚餐后增多。应用地塞米松期间10例出现胎心监护改变,停药后全部恢复正常。肌注地塞米松组新生儿高胆红素血症的发生率高于羊膜腔注射地塞米松组。结论两种用药方式均可导致糖代谢紊乱,糖代谢紊乱可能对糖耐量异常孕产妇及围生儿产生不良影响,尤以肌注地塞米松组更明显,应用时必须加强监护,同时尽量避免重复用药。

Effect of two dexamethasone regimens for acceleration of fetal lung maturation on pregnant women with IGT and neonatus

Objective: To investigate the effect of dexamethasone(DEX) on pregnant women with IGT and fetus using different injection methods.Methods:From June 2005 to June 2006,40 cases pregnant women with IGT(impaired glucose tolerance) were divided into Group A,received DEX intramuscular injection,and Group B with DEX amniotomy.TO investigate the changes in blood glucose,urinary keto-bodies,and fetal heart rate monitoring and the incidence of fetal distress and hyper-cholesterolemia were compared among the groups.Results:After DEX intramuscular injection,2h postdiet blood glucose were enhanced significiently,and urinary keto-bodies after supple also increased.During the DEX therapy,10 cases have some changes in fetal heart rate monitoring,and all came back to the normal after the therapy.In Group A,the incidence of fetal hyper-cholesterolemia was higher than Group B.Conclusion:The two DEX therapy methods could due to glucometabolism disturbance,which could made some harmful effect to the pregnant women with IGT and fetal and neonatus.DEX intramuscular injection could increased this kind of the risk.More observers should be applied in the DEX therapy,and repeated therapy should be avoided.