中国实用妇科与产科杂志

中国实用妇科与产科杂志 ›› 2023, Vol. 39 ›› Issue (2): 157-160.DOI: 10.19538/j.fk2023020109

• 专题笔谈 • 上一篇    下一篇

硫酸镁预防早产儿中枢神经系统严重并发症的临床应用现状

  

  1. 1.山东省妇幼保健院产科 国家卫生健康委生育调控技术重点实验室，山东 济南 250014；2.山东第一医科大学附属省立医院，山东 济南 250021

  • 出版日期:2023-02-02 发布日期:2023-03-02
  • 通讯作者: 王谢桐

Prevention of severe central nervous system complications in premature infants by magnesium sulfate：current situation.

  1. Department of Obstetrics，Maternal and Child Health Care Hospital of Shandong Province，Key Laboratory of Birth Regulation and Control Technology of National Health and Family Planning Commission of China，Jinan 250014，China
  • Online:2023-02-02 Published:2023-03-02

摘要： 推荐产前应用硫酸镁保护胎儿神经发育，减少脑瘫和脑瘫严重程度。24h内存在早产高风险的妊娠，包括未足月胎膜早破、胎膜完整的早产临产、胎儿或母体指征所致的计划性早产，均建议使用硫酸镁进行胎儿神经保护。应在分娩前24h内启用硫酸镁治疗。硫酸镁首负荷4g，20～30min内静脉输注，后续1g/h维持直至分娩或24h。初始疗程后未分娩的妊娠从再次用药中获益的数据有限，故目前并不推荐重复使用硫酸镁。如果预计在32孕周前分娩，使用硫酸镁可以降低存活新生儿脑瘫的严重程度和风险，而不需考虑胎儿数量。胎儿生长受限如果在＜32孕周分娩，应使用硫酸镁保护胎儿和新生儿神经。

关键词: 硫酸镁, 早产儿, 脑瘫, 神经保护

Abstract: Prenatal application of magnesium sulfate is recommended to protect fetal neural development and reduce cerebral palsy and the severity of cerebral palsy.The use of magnesium sulfate for fetal neuroprotection is recommended for pregnancies with high risk of preterm delivery within 24 hours，including premature rupture of membranes before full term，premature delivery with intact membranes，and planned preterm delivery due to fetal or maternal indications.Magnesium sulfate therapy should be started within 24 hours before delivery. Magnesium sulfate was infused intravenously within 20-30 min after initial loading of 4 g and maintained at 1 g/h until delivery or 24h.Repeated use of magnesium sulfate is not recommended currently because of limited data on the benefit of retreatment for unborn pregnancies after the initial course of treatment.If delivery is expected before 32 weeks of gestation，the use of magnesium sulfate reduces the severity and risk of cerebral palsy in surviving infants，regardless of the number of fetuses.If FGR is delivered at ＜ 32 weeks of gestation，magnesium sulfate should be used to protect the nerves of the fetus and newborn.

Key words: magnesium sulfate, premature infants, cerebral palsy, protection of nerves

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