糖皮质激素地塞米松不同给药途径对于妊娠期糖尿病患者促胎儿肺成熟的作用及其对血糖的影响

摘要

目的：观察和探讨糖皮质激素地塞米松不同给药途径对于妊娠期糖尿病患者促胎儿肺成熟的作用及其对血糖的影响。方法选择2011年1月～2014年7月我院收治的60例孕期在终止妊娠前需要使用地塞米松进行促胎儿肺成熟治疗的妊娠期糖尿病患者，在签署知情同意书后，随机分为羊膜腔注射组和肌肉注射组，每组30例。观察对比两组患者的血糖水平，羊水中的SPA以及新生儿并发症的发生情况。结果相对于羊膜腔注射组，肌肉注射组注射地塞米松后，高于治疗前，高于羊膜腔注射组治疗后，差异具有统计学意义（P＜0.05），并且高血糖持续的水平较长。羊膜腔注射组羊水中表面活性物质的SPA高于肌肉注射组，并且具有显著性差异（P＜0.05）。两组新生儿的低血糖，酸中毒以及RDS发生率均无显著性差异（P＞0.05）。结论羊膜腔内注射地塞米松对妊娠期糖尿病患者的血糖水平影响更小，更容易促进胎儿的肺成熟。%Objective To observe and investigate the effect of different routes of administration of glucocorticoid dexamethasone on promoting fetal lung maturation in patients with gestational diabetes mellitus and its effect on blood glucose.Methods 60 cases of patients with gestational diabetes mellitus who were termination of pregnancy before need using dexamethasone to promote fetal lung maturation were chosen from January 2011 to July 2014 in our hospital, after signing the informed consent, they were randomly divided into amniotic cavity injection group and intramuscular injection group, each group had 30 cases. The Blood glucose levels, SPA and neonatal complications of the two groups were observed and compared.ResultsCompared with the injection group, the blood glucose of the muscle injection group was signiifcantly higher than before treatment, and it was signiifcantly higher than that of the treatment group (P<0.05). SPA of surfactant in amniotic cavity injection of amniotic lfuid group was significantly higher than that of intramuscular injection group, and there was a signiifcant difference (P<0.05). There were no diferrence referring to the complications (P>0.05).Conclusion The effect of dexamethasone on the levels of blood glucose in patients with gestational diabetes mellitus is smaller, and it is more likely to promote fetal lung maturation.