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用于预防早产并发症的皮质类固醇治疗。

Corticosteroid treatment for prevention of prematurity complications.

作者信息

Celik C, Acar A, Cicek N, Koc H, Ak D, Akyurek C

机构信息

Faculty of Medicine Department of Obstetrics and Gynecology, Selcuk University, 42080-Akyokus/Konya, Turkiye.

出版信息

Arch Gynecol Obstet. 2002 Dec;267(2):90-4. doi: 10.1007/s00404-001-0271-6.

Abstract

OBJECTIVE

To investigate of efficiency to corticosteroid treatment for prevention of respiratory distress syndrome and other prematurity complications.

MATERIALS AND METHODS

One thousand and six babies born at 26-36(th) gestational age were investigated for following parameters; the development of respiratory distress syndrome, necessity of surfactant therapy, mean duration of daily ventillatory support, rates of Grade III or IV intraventricular hemorrhage, and periventricular leukomalacia, necrotizing enterocolitis, proven neonatal sepsis and neonatal death. Antenatal steroids were administered in the form of two 12-mg intramuscular doses of betamethasone 12 h apart as a total 24 mg in the 24 h and repeat courses of two 12 mg of betamethasone every 7 days after the first dose of the last course if undelivered. Babies were divided into 4 groups based on betamethasone

TREATMENT

The first group or control group didn't received treatment; the second group received treatment and delivered within 12 h after first injection; the third group delivered 12-24 h after first injection; and fourth group delivered at least 24 h after first injection. The patients ongoing pregnancy at least 1 week were divided into two groups as a single dose and multiple courses in once a week.

RESULTS

Significant difference for development of respiratory distress syndrome between fourth group and others was found (p=0.029). There were significant difference for respiratory distress syndrome rate in hypertensive and premature rupture of membranes groups between fourth group and control group (p=0.002, p=0.041). There weren't significant difference for RDS between repeat doses and single dose groups (p>0.05).

CONCLUSION

Single dose corticosteroid is an effective treatment for the development of RDS and the prevention of other prematurity complications.

摘要

目的

探讨皮质类固醇治疗预防呼吸窘迫综合征及其他早产并发症的疗效。

材料与方法

对1006例孕26 - 36周出生的婴儿进行以下参数调查:呼吸窘迫综合征的发生情况、表面活性物质治疗的必要性、每日通气支持的平均持续时间、III级或IV级脑室内出血、脑室周围白质软化、坏死性小肠结肠炎、确诊的新生儿败血症及新生儿死亡发生率。产前类固醇以肌肉注射两次12毫克倍他米松的形式给药,间隔12小时,24小时内总量为24毫克,若未分娩,在最后一疗程首剂后每7天重复给予两次12毫克倍他米松。根据倍他米松的使用情况将婴儿分为4组。

治疗

第一组或对照组未接受治疗;第二组接受治疗并在首次注射后12小时内分娩;第三组在首次注射后12 - 24小时分娩;第四组在首次注射后至少24小时分娩。妊娠持续至少1周的患者分为单剂量组和每周一次多疗程组。

结果

发现第四组与其他组在呼吸窘迫综合征的发生上存在显著差异(p = 0.029)。第四组与对照组相比,高血压组和胎膜早破组的呼吸窘迫综合征发生率存在显著差异(p = 0.002,p = 0.041)。重复剂量组和单剂量组之间的呼吸窘迫综合征发生率无显著差异(p>0.05)。

结论

单剂量皮质类固醇是治疗呼吸窘迫综合征及预防其他早产并发症的有效方法。

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