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产前糖皮质激素疗程对晚期早产儿呼吸窘迫综合征的影响

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目的 探讨产前糖皮质激素(antenatal corticosteroid,ACS)疗程对晚期早产儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的影响.方法 回顾性分析2019年6月至2022年6月我院胎龄在34周≤胎龄<37周的晚期早产儿的病案资料,按是否规范使用ACS促进胎肺成熟将其分为规范组(n=71)和不规范组(n=79)、规范组发生NRDS(n=27)和不规范组发生NRDS(n=36).分析使用ACS规范性对NRDS发生率的影响,以及对NRDS晚期早产儿有创通气时间、无创通气时间、住院时间、住院费用、是否使用肺表面活性物质(pulmonary surfactant,PS)及合并症等的影响.结果 规范组较不规范组胎龄大,差异有统计学意义(P<0.05).规范组发生NRDS与不规范组发生NRDS相比胎龄大(P<0.05),以及PS使用例数、有创通气时间和住院费用减少(P<0.05),脑室内出血发生率降低(P<0.05).结论 虽然规范使用ACS不能降低NRDS发生率,但可改善患儿病情,减少PS使用、有创通气时间及住院费用,降低脑室内出血发生率,且未增加其他并发症发生率.
Effect of antenatal corticosteroid therapy on respiratory distress syndrome in late preterm infants
Objective To investigate the effects of antenatal corticosteroid(ACS)therapy on neonatal respiratory distress syndrome(NRDS)in late preterm infants.Methods Medical records of late preterm infants whose gestational age was 34 weeks≤age<37 weeks,from June 2019 to June 2022 were retrospectively analyzed.According to whether the use of ACS was standardized to promote fetal lung maturation,they were divided into normative group(n=71)and non-normative group(n=79),NRDS in normative group(n=27)and NRDS in non-normative group(n=36).The effects of ACS on the incidence of NRDS,invasive ventilation time,non-invasive ventilation time,hospital stay,hospitalization costs,the use of pulmonary surfactant(PS)and complications were analyzed.Results The gestational age of normative group was higher than that of non-normative group,and the difference was statistically significant(P<0.05).The occurrence of NRDS in the normative group was larger than that in the non-normative group(P<0.05),and the number of PS users,invasive ventilation time and hospitalization costs were decreased(P<0.05),and the incidence of intracranial hemorrhage was decreased(P<0.05).Conclusion Although the standard use of ACS can't reduce the incidence of NRDS,but it can improve the condition of children,reduce the use of PS,invasive ventilation time and hospitalization costs,reduce the incidence of intraventricular hemorrhage,and do not increase the incidence of other complications.

prenatal glucocorticoidcourse of treatmentlate preterm birthneonatal respiratory distress syndromepulmonary surfactant

耿爱桥、蒋文静、张志芳

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衡水市妇幼保健院新生儿科,河北衡水 053010

产前糖皮质激素 疗程 晚期早产儿 新生儿呼吸窘迫综合征 肺表面活性物质

衡水市科技计划

2021014046Z

2024

世界临床药物
上海医药工业研究院

世界临床药物

CSTPCD
影响因子:0.849
ISSN:1672-9188
年,卷(期):2024.45(2)
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