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目的探讨纤维蛋白胶修复未足月胎膜破口的临床应用效果。方法选取2011年1月-2015年12月收治的114例妊娠24~32周发生胎膜早破的孕妇,根据治疗方案分为对照组(70例)和修复组(44例)。对照组孕妇给予卧床、抬高臀部、常规胎心监护,预防感染、抑制宫缩和促胎肺成熟等处理;修复组在此基础上采用纤维蛋白胶修复治疗。观察两组治疗效果。结果治疗1周后,修复组羊水池最大深度显著高于对照组,差异有统计学意义(P<0.05);两组胎儿治疗1周后的双顶径增长值比较差异无统计学意义(P>0.05)。修复组分娩孕周及延长孕周时间均显著长于对照组,差异均有统计学意义(P<0.05)。修复组新生儿体重、1 min Apgar评分均显著高于对照组,差异均有统计学意义(P<0.05);两组宫内感染发生率、新生儿窒息发生率、新生儿死亡率比较差异均无统计学意义(P>0.05)。修复组治愈率(52.27%)显著高于对照组(34.29%),差异有统计学意义(χ~2=3.597,P<0.05)。修复组孕妇返回病房即未见活动性阴道流水,未出现过敏反应,血常规、C-反应蛋白、血沉均在正常范围,阴道分泌物细菌培养显示无致病菌生长。结论纤维蛋白胶修复未足月胎膜破口能够显著延长孕周、提高新生儿出生体重及1 min Apgar评分,同时不会增加新生儿不良结局发生率。
Objective To investigate the clinical effect of fibrin glue in repairing unexplained fetal membranes. Methods From January 2011 to December 2015, 114 pregnant women with premature rupture of membranes who had been pregnant between 24 and 32 weeks were divided into control group (70 cases) and repair group (44 cases) according to the treatment plan. The control group of pregnant women given bed, raise the buttocks, routine fetal heart monitoring, prevention of infection, inhibition of contractions and promote fetal lung maturation and other treatment; repair group on this basis using fibrin glue repair treatment. Observation of two groups treatment effect. Results After 1 week of treatment, the maximum depth of amniotic fluid pool in the repair group was significantly higher than that in the control group (P <0.05). There was no significant difference in biparietal diameter growth value between the two groups after 1 week of treatment (P > 0.05). The gestational weeks and prolonged gestational weeks of the repairing component were significantly longer than those of the control group, with significant differences (P <0.05). The body weight of neonates in repair group was significantly higher than that in control group at 1 min (P <0.05). The incidence of intrauterine infection, neonatal asphyxia and neonatal mortality in both groups were significantly different No statistical significance (P> 0.05). The cure rate of the repair group (52.27%) was significantly higher than that of the control group (34.29%), the difference was statistically significant (χ ~ 2 = 3.597, P <0.05). Repair group of pregnant women returned to the ward that no active vaginal fluid, no allergic reactions, blood, C-reactive protein, erythrocyte sedimentation rate are within the normal range, vaginal secretions bacterial growth showed no pathogenic bacteria. Conclusion Fetal fibrin glue repairs incomplete fetal membrane rupture can significantly prolong gestational age, increase newborn birth weight and 1 min Apgar score, without increasing the incidence of neonatal adverse outcomes.