孕妇胎膜早破合并羊膜腔感染综合征的临床分析及治疗  

Clinical analysis and treatment to premature rupture of membranes combining intraamniotic infections

作　　者：王翠花 陶莉莉 朱红燕 

机构地区：[1]无锡市第九人民医院妇产科,江苏无锡214062

出　　处：《中华医院感染学杂志》2014年第12期3054-3056,共3页Chinese Journal of Nosocomiology

基　　金：无锡市卫生局基金资助项目(WW-2010B-1026)

摘　　要：目的分析孕妇胎膜早破合并羊膜腔感染综合征(IAIS)的发生原因、临床特点及诊断治疗方法,以期为临床提高胎膜早破合并羊膜腔感染综合征诊治水平提供参考。方法选择医院2012年3月-2013年3月46例胎膜早破合并羊膜腔感染综合征孕妇作为研究组,同时选择同期46例胎膜早破未发生羊膜腔感染综合征孕妇作为对照组,分析两组孕妇临床表现、产妇及新生儿结局,并进行对症治疗。结果破膜时间长、破膜后反复阴道检查、合并阴道炎、破膜前有性生活史是诱发羊膜腔感染综合征的主要原因;孕妇主要的临床表现是末梢血白细胞>15×109/L,发生率为97.83%,其次为C-反应蛋白>8mg/L、体温>37.8℃、孕妇心率>100/min等,发生率分别为78.26%、76.09%、34.78%;观察组剖宫产、产程延长、产褥感染、产后出血的发生率明显高于对照组,观察组围产儿感染、胎儿宫内窘迫、新生儿窒息、围产儿死亡发生率明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论胎膜早破是羊膜腔感染综合征的重要诱因,要降低羊膜腔感染综合征的发生率,应注重健康教育,同时控制和规范医源性操作,一旦发生胎膜早破,针对IAIS高危因素,积极采取有效地预防措施,避免羊膜腔感染综合征的发生。OBJECTIVE To analyze the causes ,clinical features ,diagnosis and treatment methods of premature rupture of membranes combining IAIS ,so as to provide reference data to lift diagnosis and treatment level of the symptoms .METHODS 46 cases of hospitalized gravitas were selected during Mar 2012 to Mar 2013 due to premature rupture of membranes combining IAIS ,and 46 cases having premature rupture of membranes but not suffered from IAIS were selected as the control group ;the clinical situation of the two groups and conditions of puerperal and newborns were analyzed ,and symptomatic treatment was conducted for them .RESULTS The main causes of intraamniotic were long-time rupture of membranes , repeated internal examination after rupture of membranes ,colpitis and sex ;the main clinical signs of puerperal ：the leucocyte in peripheral blood were more than 15 × 109/L with an occurrence rate of 97 .83% ,and the C-reactive protein was more than 8 mg/L ,the temperature exceeded 37 .8 ℃ and heart rate exceeded 100/min and so on ,with an occurrence rate of 78 .26% ,76 .09% and 34 .78% respectively .The occurrence rates of caesarean section ,lengthened stage of labor ,puerperal infection and postpartum hemorrhage in the conversation group were significantly higher than those in control group ;also ,the occurrence rates of perinatal infections ,fetal distress in uterus ,neonatal asphyxia and dead perinatal infants were significantly higher than those in control group （P〈0 .05） .CONCLUSIONS Premature rupture of membranes is the main cause of IAIS ;with the purpose of reducing the occurrence rate of IAIS ,it is necessary to focus on health education ,control and regulate iatrogenic operations . If it occurs premature rupture of membranes , effective preventive measures should be taken as early as possible to avoid IAIS .

关 键 词：胎膜早破 羊膜腔感染综合征 临床 治疗 

分 类 号：R714.433[医药卫生—妇产科学]