中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
10期
1820-1824
,共5页
胎膜早破%妊娠结局%潜伏期
胎膜早破%妊娠結跼%潛伏期
태막조파%임신결국%잠복기
Fetal membranes,premature rupture%Pregnancy outcome%Latency period
目的：分析不同孕周发生的未足月胎膜早破（PPROM）及其潜伏期（latency period）对妊娠结局的影响探讨临床最佳干预时机。方法对2010年1月1日至2013年12月31日在我院分娩的383例（28～36+6周）单胎头位且无其他并发症的PPROM 病例及其新生儿的临床资料进行回顾性分析。按发生PPROM的孕周分为3个组：（1）孕28～31+6周；（2）孕32～33+6周；（3）孕34～36+6周。根据潜伏期不同，每个孕周段进一步分为两个组，分别对比两组不同潜伏期PPROM与妊娠结局的关系。结果孕28～31+6周组潜伏期在72 h以内的早产儿死亡率和支气管肺发育不良率显著高于潜伏期72 h以后者。孕32～33+6周组潜伏期在72 h之内者与潜伏期在72 h之后的PPROM母儿主要妊娠结局差异均无统计学意义（P＞0.05）。孕34～36+6周组潜伏期在12 h之内者与潜伏期在12 h 之后者的母儿主要妊娠结局差异均无统计学意义（P＞0.05）。结论对孕28～31+6周PPROM可采取促胎肺成熟，预防感染和抑制宫缩处理，在没有禁忌证的情况下，尽可能延长潜伏期72 h以上或34周后终止妊娠；对32～33+6周PPROM没有证据支持延长孕周72 h对妊娠结局有好处；对孕34～36+6周PPROM应考虑尽快终止妊娠；
目的：分析不同孕週髮生的未足月胎膜早破（PPROM）及其潛伏期（latency period）對妊娠結跼的影響探討臨床最佳榦預時機。方法對2010年1月1日至2013年12月31日在我院分娩的383例（28～36+6週）單胎頭位且無其他併髮癥的PPROM 病例及其新生兒的臨床資料進行迴顧性分析。按髮生PPROM的孕週分為3箇組：（1）孕28～31+6週；（2）孕32～33+6週；（3）孕34～36+6週。根據潛伏期不同，每箇孕週段進一步分為兩箇組，分彆對比兩組不同潛伏期PPROM與妊娠結跼的關繫。結果孕28～31+6週組潛伏期在72 h以內的早產兒死亡率和支氣管肺髮育不良率顯著高于潛伏期72 h以後者。孕32～33+6週組潛伏期在72 h之內者與潛伏期在72 h之後的PPROM母兒主要妊娠結跼差異均無統計學意義（P＞0.05）。孕34～36+6週組潛伏期在12 h之內者與潛伏期在12 h 之後者的母兒主要妊娠結跼差異均無統計學意義（P＞0.05）。結論對孕28～31+6週PPROM可採取促胎肺成熟，預防感染和抑製宮縮處理，在沒有禁忌證的情況下，儘可能延長潛伏期72 h以上或34週後終止妊娠；對32～33+6週PPROM沒有證據支持延長孕週72 h對妊娠結跼有好處；對孕34～36+6週PPROM應攷慮儘快終止妊娠；
목적：분석불동잉주발생적미족월태막조파（PPROM）급기잠복기（latency period）대임신결국적영향탐토림상최가간예시궤。방법대2010년1월1일지2013년12월31일재아원분면적383례（28～36+6주）단태두위차무기타병발증적PPROM 병례급기신생인적림상자료진행회고성분석。안발생PPROM적잉주분위3개조：（1）잉28～31+6주；（2）잉32～33+6주；（3）잉34～36+6주。근거잠복기불동，매개잉주단진일보분위량개조，분별대비량조불동잠복기PPROM여임신결국적관계。결과잉28～31+6주조잠복기재72 h이내적조산인사망솔화지기관폐발육불량솔현저고우잠복기72 h이후자。잉32～33+6주조잠복기재72 h지내자여잠복기재72 h지후적PPROM모인주요임신결국차이균무통계학의의（P＞0.05）。잉34～36+6주조잠복기재12 h지내자여잠복기재12 h 지후자적모인주요임신결국차이균무통계학의의（P＞0.05）。결론대잉28～31+6주PPROM가채취촉태폐성숙，예방감염화억제궁축처리，재몰유금기증적정황하，진가능연장잠복기72 h이상혹34주후종지임신；대32～33+6주PPROM몰유증거지지연장잉주72 h대임신결국유호처；대잉34～36+6주PPROM응고필진쾌종지임신；
Objective To explore the effect of different gestational weeks and latency period on pregnancy outcome in preterm premature rupture of membrane and the optimal timing of clinical intervention. Methods A retrospective study was conducted on clinical data of 383 (between 28-36+6 weeks), healthy singleton pregnant women with PPROM and neonatal information, who admitted to our hospital from January 1, 2010 to December 31, 2013.According to the different clinical treatment and different gestational weeks all subjects were divided into 3 groups: (1) 28-31+6 gestational weeks; (2) 32-33+6 gestational week;(3) 34-36+6 gestational weeks;each gestational age group were further divided into two groups, analysis the relationship between different groups of pregnant women with different latency and the maternal and neonatal outcomes. Results In 28-31+6 weeks of gestation group, neonatal mortality and bronchopulmonary dysplasia were significantly higher in group of latent period within 72 h than that in group of latent period over 72 h. In 32-33+6 weeks group, there was no statistic difference of maternal and neonatal outcomes between the group of latent period over 72 h and the group of within 72 h. In 34-36+6 weeks group, there was no statistic difference of maternal and neonatal outcomes between the group of latent period over 12 h and the group of within 12 h. Conclusions The patients with PPROM at 28-31+6 gestational weeks, the suitable measures to treat are promoting fetal lung maturation, preventing infection, tocolysis to prolong latency period more than 72 h or until 34 weeks if there were no contraindications. The patients with PPROM at 32-33+6 gestational weeks, There is no evidence to support prolong gestational age 72 h is good for pregnancy outcome. To the patients with PPROM at 34-36+6 gestational weeks, the suitable measure is proceeding to delivery as early as possible.
