目的 探讨不同产前皮质类固醇应用状况早产儿神经功能缺陷和预后情况.方法 回顾性分析早产先兆孕妇80例,其中持续早产先兆孕妇28例(A组),采用单疗程产前皮质类固醇(地基米松)治疗,52例早产先兆孕妇(B组)采用多疗程地塞米松治疗.统计比较两组新生儿缺氧缺血性脑病(HIE)发生率、新生儿血清神经元特异性烯醇化酶(NSE)浓度、新生儿行为神经评分(NBNA)、呼吸窘迫综合征(RDS)发生率、围生期死亡率、新生儿体重及母体并发症发生率等.结果 A组和B组HIE发生率、新生儿出生时和出生3d的血清NSE浓度、NBNA评分、RDS发生率及围生期死亡率比较差异均无统计学意义(P＞0.05).B组新生儿体重低于A组[(2 511.72 ±203.36)g vs.(2 721.42±241.15)g,P＜0.05],且母体并发症发生率升高(P＜0.05).结论 不同产前皮质类固醇应用状况早产儿神经功能缺陷和预后无明显差异,多疗程产前皮质类固醇治疗可影响新生儿体重,且在一定程度上增加了母体并发症的发生,持续先兆早产治疗前,应充分考虑多疗程产前皮质类固醇治疗的利弊,并在治疗中积极采取措施,缓解其不良反应.%Objective To investigate the neurological deficits and prognosis in preterm infants treated with different use of antenatal corticosteroids.Methods Totally 80 pregnant women with threatened preterm labor were retrospectively analyzed,in which 52 pregnant women with lasting threatened preterm labor (group A) were treated with multiple courses of antenatal corticosteroids (dexamethasone treatment),and 28 cases of pregnant women with threatened preterm labor (group B) were treated with single course of dexamethasone treatment.Neonatal hypoxic ischemic encephalopathy (HIE) rate,serum neuron specific enolase (NSE) concentration,neonatal behavioral neurological score (NBNA),respiratory distress syndrome (RDS) rate,perinatal mortality,neonatal birth weight and maternal complications rate of two groups were compared.Results There was no significant difference in the HIE rate,serum NSE concentration,NBNA score,RDS score or perinatal mortality between group A and group B (P ＞ 0.05).The body weight of group A was higher than that of group B:(2 721.42 ± 241.15) g vs.(2 511.72 ± 203.36) g (P ＜ 0.05),while the rate of maternal complications was lower in group A(P ＜ 0.05).Conclusion There is no significant difference in the defect and prognosis of premature nerve function between the different application of antenatal corticosteroids,but multiple courses of antenatal corticosteroids can affect neonatal body mass and increase the incidence of maternal complications to a certain extent;therefore,the pros and cons in multiple courses of antenatal corticosteroids should be fully considered before threatened premature delivery treatment,and the treatment measures should be taken actively to alleviate the side effects.
展开▼
