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目的:明确药物治疗对先兆早产的必要性。方法:选择200例妊娠满28～35周有先兆早产征兆患者,其中100例未予药物治疗,100例给予药物治疗。所有入选者均进行多因素综合评分。采用固相免疫吸附法检测宫颈分泌物中fFN;采用阴道超声测量宫颈长度,并据此计算宫颈指数;采用放射免疫法测定促肾上腺激素释放激素水平,速率散射浊度法测定C-反应蛋白水平。结果:综合评分7～9分者,未予药物治疗者早产发生率为100.00%,平均36 h内分娩,给予药物治疗者早产发生率100.00%,平均在61 h内分娩,药物治疗对于早产发生无阻止作用,但可延长发病至分娩的时间;综合评分4～6分者,未予药物治疗者早产发生率为90.00%(27/30),平均92 h内分娩,给予药物治疗者早产发生率为70.00%(21/30),平均在121 h内分娩,药物治疗对于早产发生有阻止作用,但无统计学意义(P>0.05),延长发病至分娩的时间较明显,有统计学意义(P<0.05);综合评分1～3分者,未予药物治疗者早产发生率为30.00%(9/30),平均在121 h内分娩,给予药物治疗者早产发生率为23.33%(7/30),平均在161 h内分娩,药物治疗对于早产发生有阻止作用,但无统计学意义(P>0.05),延长发病至分娩的时间较明显;综合评分0分者,未予药物治疗者早产发生率为3.33%(1/30),药物治疗对于早产发生率无影响。结论:可根据多种因素综合评分来决定是否需要药物治疗先兆早产,进一步明确药物治疗的指征。
OBJECTIVE: To clarify the need for medical treatment of threatened preterm labor. Methods: 200 pregnant women with threatened signs of preterm birth were enrolled from 28 to 35 weeks of pregnancy, of whom 100 were not treated with drugs and 100 were given drugs. All participants were scored on a multi-factor scale. Cervical secretions were detected by solid-phase immunosorbent assay (FACS). Cervical length was measured by vaginal ultrasound and cervical index was calculated. The level of corticotropin-releasing hormone was measured by radioimmunoassay and C-reactive protein . Results: The average rate of preterm birth was 100.00% in the patients who had not received drug treatment and the average rate of premature delivery was 100.00% within 36 hours. The rate of premature delivery was 100.00% No effect of preventing, but can extend the onset of childbirth time; comprehensive score of 4 to 6 points, no drug treatment, the incidence of preterm birth was 90.00% (27/30), the average delivery within 92 h, given premature delivery of drug treatment occurred The rate was 70.00% (21/30), the average delivery within 121 h, drug treatment for the prevention of preterm birth, but no statistical significance (P> 0.05), prolonged onset of labor to delivery time was significantly, statistically significant (P <0.05). The average rate of preterm delivery was 30.00% (9/30) in patients with a total score of 1 to 3, and was delivered within 121 hours on average. The incidence of preterm delivery was 23.33% (7 / 30), the average delivery within 161 h, drug treatment for the prevention of preterm birth, but no statistically significant (P> 0.05), prolonged onset to delivery time is more obvious; comprehensive score of 0, no drug treatment Prevalence of preterm birth was 3.33% (1/30), drug treatment had no effect on the incidence of preterm birth. Conclusion: According to a variety of factors comprehensive score to decide whether the need for drug treatment of threatened preterm labor, to further clarify the indications for drug treatment.