摘要
目的 探讨不同条件下肾上腺皮质激素预防早产儿肺透明膜病 (HMD)的效果。方法观察用药组 (n =12 0 )与未用药组 (n =40 )早产儿HMD的发生率 ;观察不同用药时间、剂量及高危条件(窒息、多胎妊娠、性别 )时对早产儿HMD发病的影响 ;监测呼吸机治疗的HMD患儿肺泡动脉血氧分压 (Aa DO2 )与呼吸指数 (RI)的变化。结果 (1)产前 2 4h以上用药组与未用药组相比 ,用药组HMD的发病率明显降低 ,尤其 2 8～ 34周的早产儿 ,发生率由 5 7.1%降至 16 .7%。 (2 )用药组呼吸机治疗者Aa DO2 与RI值分别为 (2 2 7± 6 0 )mmHg(1mmHg =0 .133kpa)、5± 4,低于未用药组的 (34 7± 12 6 )mmHg、9± 6 ,差异有显著性。 (3)在多胎妊娠时 ,用药组HMD的发生率仍低于未用药组 ,分别为 0 %与6 6 .7% ;用药组女婴HMD的发生率低于男婴 ,分别为 0 %与 10 .3%。结论 (1)产前应用肾上腺皮质激素预防早产儿HMD的最佳时间为产前 2 4h～生后 7d ;最佳阶段为孕 2 8～ 34周。 (2 )激素可以降低早产儿HMD的发生率 ,减轻严重程度 ,改善预后。 (3)激素对多胎妊娠的HMD仍有预防效果 ;女婴对激素的敏感度高于男婴。
Objective To explore the effect of antenatal corticosteroids administration on the incidence of hyaline membrane disease(HMD) in preterm neonates. Methods Maternal and neonatal medical records were reviewed between 28～36 weeks gestation over the period of January 1, 1995 to August 31, 1998. One hundred and twenty cases received steroid treatment, 60 cases did not. The incidences of HMD in two groups were compared, Alveolo arterial oxygen partial pressure difference (Aa DO 2) and respiratory index (RI) were measured. Results (1) The statistics showed some differences in the incidences of HMD in the optimal steroid compared to the group without the steroid treatment, the incidence of HMD in the optimal was reduced from 57.1% to 16.7%. (2) Aa DO 2 and RI of preterm neonates with HMD in optimal steroid group were (227±60) mmHg and 5±4, and were significantly lower than those without the treatment, (347±126)mmHg and 9±6. (3) The therapy with corticosteroids showed a reduction in the incidence of HMD in preterm multiple pregnancy. The incidences of HMD in the two groups with and without steroid treatments were 0% and 66.7%, respectively. In the optimal steroid group the incidence of HMD in female infants was 0%, which was lower than that in male infants, 10.3%. Conclusions Antenatal corticosteroids did not only reduce the incidence and severity of HMD, but also had effects on multiple pregnancy. The sensitivity of antenatal corticosteroids in female preterm neonates was higher than that in male preterm neonates.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2000年第3期137-139,共3页
Chinese Journal of Pediatrics
关键词
早产儿
肺透明膜病
肾上腺皮质激素
预防
Infant, premature
Hyaline membrane disease
Adrenal cortex hormones
