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目的:探讨地塞米松联合过氧化碳酰胺对第二产程中胎儿宫内窘迫治疗的可行性及疗效。方法:第二产程中出现胎儿宫内窘迫356例,随机分为治疗组(予50%葡萄糖注射液20 ml加地塞米松针10 mg静脉推注+10%葡萄糖注射液250 ml+过氧化碳酰胺针1.0 g缓慢静脉滴注+常规治疗)和对照组(鼻吸氧+50%葡萄糖注射液20 ml+维生素C针1.0 g静脉推注+常规治疗),分析两组治疗后胎心率恢复情况,比较两组分娩方式、新生儿Apgar评分及分娩时羊水性状。结果:治疗组治疗后,胎心率恢复至正常的比例显著大于对照组(P<0.01),剖宫产率显著低于对照组(P<0.01),阴道手术率显著低于对照组(P<0.05),自然分娩率显著高于对照组(P<0.01),Apgar评分≥8分的新生儿比例显著高于对照组(P<0.01),羊水性状较对照组好。结论:地塞米松联合过氧化碳酰胺可有效改善宫内窘迫胎儿的缺氧状态,降低手术产率,减少新生儿窒息率,为进一步治疗赢得了宝贵时间,值得临床推广使用。
Objective: To investigate the feasibility and efficacy of dexamethasone combined with carbamide in the treatment of fetal distress in the second stage of labor. Methods: 356 cases of fetal distress in the second stage of labor were randomly divided into treatment group (50% glucose injection 20 ml plus dexamethasone needle 10 mg intravenous injection + 10% glucose injection 250 ml + peroxynitrite needle 1.0 g slow intravenous infusion + routine treatment) and control group (nasal oxygen + 50% glucose injection 20 ml + vitamin C needle 1.0 g intravenous bolus + routine treatment), analysis of the recovery of fetal heart rate after two groups compared Two groups of delivery mode, Apgar score neonatal and amniotic fluid during childbirth traits. Results: After treatment, the rate of fetal heart rate returned to normal was significantly higher than that of the control group (P <0.01), and the rate of cesarean section was significantly lower than that of the control group (P <0.01). The vaginal surgery rate was significantly lower than that of the control group <0.05). The rate of natural childbirth was significantly higher than that of the control group (P <0.01). The percentage of neonates with Apgar score ≥8 was significantly higher than that of the control group (P <0.01). Conclusion: Dexamethasone combined with carbamide can effectively reduce the fetal hypoxia status, reduce the surgical yield and reduce neonatal asphyxia rate, which has won valuable time for further treatment and is worthy of clinical promotion.