摘要
目的:探讨静脉注射地塞米松预防阴道分娩、剖宫产术羊水栓塞(AFE)的临床疗效。方法:选择2001年3月-2007年12月在湖北省天门市妇幼保健院产科住院分娩的孕妇10728例作为试验组,与同期在该院产科住院分娩的孕妇10812例作为对照组,试验组在阴道分娩破膜前10min和剖宫产于手术前10min静脉注射地塞米松10mg,高危分娩和高危手术者另静脉滴注地塞米松10～20mg,对照组不用地塞米松,观察2组AFE的发病率、产后出血的发病率、新生儿窒息的发病率。结果:AFE的发病率:试验组0.19‰,对照组1.02‰,比较差异有统计学意义(P<0.05);产后出血的发病率:试验组0.98%,对照组6.49%,比较差异有统计学意义(P<0.01);新生儿窒息的发病率:试验组5.87%,对照组17.19%,比较差异有统计学意义(P<0.01)。结论:分娩前和手术前静脉注射地塞米松可起到预防AFE的作用,同时还可降低产后出血和新生儿窒息的发病率,可作为阴道分娩和手术前的预防性用药推广应用。
Objective：To investigate the clinical effects of intravenous dexamethasone for prevention of amniotic fluid embolism during vaginal delivery and cesarean section. Method： 10 728 cases of pregnant women, who delivered during the period March 2001 to December 2007 in our hospital were chosen as the test group. 10 812 cases of pregnant women who delivered synchronically were chosen as the control group. In the test group, both cases of vaginal delivery and cesarean section were intravenous injection of 10 mg dexamethasone 10 minutes before rupture of fetal membranes or operation respectively. Those patients with high risk took another 10-20 mg. Dexamethasone was not used in the control group. The incidence of amniotie fluid embolism, postpartum hemorrhage and neonatal asphyxia of the two groups were observed. Result： The incidence of amniotic fluid embolism for the test group was 0.19‰, whereas the control group was 1.02‰. The difference is statistically significant （ P〈0.05）. The incidence of postpartum hemorrhage for the test group was 0. 98%, whereas the control group was 6.49%. The difference is statistically significant （ P〈0.01）. In the test group, the incidence of neonatal asphyxia was 5.87%, whereas it was 17. 19% for the control group. The difference is statistically significant （P〈 0.01）. Conclusion： Intravenous injection of dexamethasone before vaginal delivery or cesarean section can prevent amniotic fluid embolism. Meanwhile, this method can decrease the incidence of postpartum hemorrhage and neonatal asphyxia. This method can be popularized and applied as a preventive medicine before vaginal delivery and cesarean section.
出处
《临床急诊杂志》
CAS
2009年第2期83-85,共3页
Journal of Clinical Emergency
关键词
羊水
阴道分娩
剖宫产术
预防
amniotic fluid embolism
vaginal delivery
cesarean section
prevention
