胎膜早破对新生儿健康危害的研究  

Influence of premature rupture of membranes on neonatal health

作　　者：吴静[1,2] 刘敬[1] 封志纯[1] 黄俊锦[1] 吴刚[1] 

机构地区：[1]北京军区总医院附属八一儿童医院新生儿科,100700 [2]南方医科大学附属珠江医院儿科,广州

出　　处：《中华儿科杂志》2009年第6期452-456,共5页Chinese Journal of Pediatrics

摘　　要：目的探讨胎膜早破（PROM）对新生儿健康的影响。方法对我院3320例住院新生儿资料进行回顾性分析，其中PROM患儿711例。用系统抽样法随机选取各100例足月PROM及未足月PROM患儿，与正常新生儿进行对照分析。结果25％（178／711）PROM患儿发生各种感染性疾病，其中肺炎与败血症占87．1％（155／178），主要为感染性肺炎（92／711，12。9％）和败血症（63／711，8．9％）。血培养阳性率38．7％（63／163），主要致病菌为G’球菌（45．9％）和G～杆菌（54．1％）；检出呼吸窘迫综合征69例，占9．7％（69／711）；PROM的新生儿血小板计数减少，宽度变窄，血小板平均容积增加，P〈0．01；多项红细胞参数值高于正常组（P〈0．05）；心肌酶谱明显异于正常组（P〈0．05）；PROM对新生儿的电解质水平无明显影响；PROM的足月儿及早产儿平均住院时间分别延长20．O％、25．1％（P〈0．05）；平均住院费用足月儿增加30．5％，早产儿则增加60．0％，P〈0．05。结论PROM可对新生儿健康造成多方面危害，应加强对PROM的研究，及时采取合理措施，减少对新生儿健康的危害。Objective To observe the influence of premature rupture of membranes （PROM） on neonatal health. Method A retrospective cohort study was conducted among 3320 in-patient newborns of Bayi Children＇s Hospital from October 2006 to March 2008. One hundred term newborns and one hundred preterm newborns with PROM were chosen to be compared with fifty normal term newborns and preterm newborns respectively. The data were analyzed with Minitab 12.0 software. Result Of the 3320 newborns, 711 （21.4%） were complicated with PROM. The morbidity of PROM was 21.4% （ 711/3320）, among whom 9.69% （196/2022） were term newborns, 39. 68% （515/1298） were preterm newborns, the differences between the term and the preterm newborns were statistically significant （ P 〈 0. 001 ）. Preterm newborns with PROM accounted for 72. 43% of all PROM newborns （515/711 ）. However, preterm infants only accounted for 30. 01% of the newborns without PROM. Sixty-nine newborns with PROM had neonatal respiratory distress syndrome （RDS）, incidence of which was 9. 7% （69/711） ： 10 （5.1%） term newborns and 59 （ 11.5% ） preterm newborns, of whom 3 developed broncho-pulmonary dysplasia. Among all patients with PROM, 25% （178/711 ） newborns had different infectious diseases： 92 （12.9%） had pneumonia and 63 （8.9%）had septicemia, which totally accounted for 87.1% of the patients with infectious diseases, 23 （3.2%） newborns had other infectious diseases including peritonitis, purulent meningitis, urinary system infection, skin infection, perianal infection and conjunctivitis, which accounted for 12. 9% of the patients with infectious diseases. Blood culture was performed for 163 newborns with PROM, the positive rate of the culture was 38.7% （63/163）. The main pathogenic bacteria detected in blood culture were Gram-positive eocci（45.9% ）and Gram-negative rods （54. 1% ）. Gram-positive cocci mainly included Staphylococcus haemolyticus and Staphylococcus epidermidis （16/63）. Gram-negative r

关 键 词：胎膜早破 婴儿 新生 肺炎 细菌 细菌感染 

分 类 号：R686[医药卫生—骨科学]