胎儿期应用地塞米松预防早产儿颅内出血的临床观察

目的:探讨胎儿期应用地塞米松预防不同胎龄早产儿颅内出血的临床效果.方法:将我院2015年6月-2016年6月具有早产高危因素,且分娩时胎龄<37周的186例早产儿随机分为观察组(94例)和对照组(92例),观察组孕妇分娩前静脉注射地塞米松10 mg/d,连用2 d,对照组产前母亲未给予预防措施.分别在早产儿出生后24 h、3 d、7 d行头颅超声检查,动态观察其颅内出血、出血程度及进展情况.结果:观察组小胎龄(<35周)早产儿颅内出血的发生率为41.54%(27/65例),明显低于对照组的64.06%(41/64例),差异具有统计学意义(P<0.05);而两组大胎龄(≥35周)早产儿颅内出血发生率差异无统计学意义(P>0.05).结论:胎儿期应用地塞米松对不同胎龄早产儿颅内出血的预防效果不尽相同,对不足35周早产儿颅内出血的预防作用显著.

Clinical observation on the application of dexamethasone in prevention of intracranial hemorrhage in premature infants

Objective: To evaluate the clinical effect of prenatal application of dexamethasone in preventing intracranial hemorrhage in premature infants.Methods: One hundred and eighty-six premature infants (with high risk factors for preterm delivery and gestational age < 37 weeks) born in Chengdu Women and Children's Central Hospital from June 2015 to June 2016 were randomly divided into observation group (94 cases) and control group (92 cases). The gravida in observation group received intravenous injection of dexamethasone (10 mg/d for 2 days) prior to delivery, those in control group received no preventive measures. Cranial ultrasonography was performed for the premature infants 24 hours, 3 days and 7 days after birth to dynamically observe the intracranial hemorrhage, bleeding degree and progress.Results: The incidence of intracranial hemorrhage in small gestational age premature infants (< 35 weeks) of observation group was 41.54% (27/65 cases), significantly lower than that of the control group 64.06% (41/64 cases), the difference was statistically significant (P<0.05); while for the large gestational age (over 35 weeks) premature infants, no significant difference existed between the two groups in the incidence of intracranial hemorrhage (P>0.05).Conclusion: The effect of dexamethasone on preventing intracranial hemorrhage is different depending on the gestational age of premature infants, and it may play more significant role for the premature infants with gestational age of less than 35 weeks.