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[产前给予糖皮质激素(倍他米松)预防新生儿呼吸窘迫综合征。临床结果及羊水卵磷脂/鞘磷脂比值的变化]

[Preventive treatment of respiratory distress syndrome in newborn infants with antepartal glucocorticoid administration (betamethasone). Clinical results and changes in the lecithin/sphingomyelin ratio of the amniotic fluid].

作者信息

Kühn W, Lorenz U, Rüttgers H, Kubli F

出版信息

Geburtshilfe Frauenheilkd. 1984 May;44(5):315-21. doi: 10.1055/s-2008-1036666.

Abstract

Betamethason was administered to 105 patients with threatened premature labour at risk for respiratory distress syndrome (RDS) of the newborn. The most important indications were premature rupture of the membranes (30%) and premature labour (40%). The betamethason treatment was given between the 27. and 35. week of gestation. 79% of the patients delivered prior to 36 weeks of gestation, over 50% prior to 34 weeks gestation. The total incidence of RDS was 25%. Severe types of RDS (stage III and IV) were rare (7%). The mortality of RDS after betamethason treatment was 5.4%. After 32 weeks gestation the mortality from RDS was 0%. Severe types of RDS appear to occur more often in male than in female infants. The incidence of RDS was not lowered further by premature of the membranes. The lecithin/sphingomyelin(L/S)-ratio in the amniotic fluid following treatment with betamethason increased to over 2 in only 2/3 of the cases. The predictive value of the L/S ratio that respiratory distress syndrome of the newborn only occurs rarely with values over 2 was maintained after treatment with betamethason. Our rate in cases with an L/S ratio over 2 was 7.9%.

摘要

对105例有新生儿呼吸窘迫综合征(RDS)风险的先兆早产患者给予倍他米松治疗。最重要的指征是胎膜早破(30%)和早产(40%)。倍他米松治疗在妊娠27至35周之间进行。79%的患者在妊娠36周前分娩,超过50%在妊娠34周前分娩。RDS的总发生率为25%。严重类型的RDS(Ⅲ期和Ⅳ期)很少见(7%)。倍他米松治疗后RDS的死亡率为5.4%。妊娠32周后RDS的死亡率为0%。严重类型的RDS似乎在男婴中比在女婴中更常发生。胎膜早破并未进一步降低RDS的发生率。倍他米松治疗后,仅2/3的病例羊水中卵磷脂/鞘磷脂(L/S)比值升至2以上。倍他米松治疗后,L/S比值大于2时新生儿呼吸窘迫综合征很少发生这一预测价值仍然存在。我们L/S比值大于2的病例发生率为7.9%。

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