高龄产妇胎儿宫内感染的临床分析及超声诊断  

Advanced maternal intrauterine infection clinical analysis and ultrasound diagnosis

作　　者：蒋江帆[1] 覃艳玲[1] 赵泊[1] 梁凤玲[1] 

机构地区：[1]南宁市妇幼保健院超声科,广西南宁530011

出　　处：《中华医院感染学杂志》2014年第15期3849-3851,共3页Chinese Journal of Nosocomiology

基　　金：广西省卫生厅重点基金资助项目(GW-2010B-1019)

摘　　要：目的分析高龄产妇胎儿宫内感染的类型及临床表现,对超声诊断的临床价值进行探讨,为临床资料提供参考依据。方法对2010年3月-2013年3月医院92例高龄产妇胎儿宫内感染病例进行分析,所有产妇均行超声检查,对诊断价值进行探讨。结果感染排列顺位依次是细菌、乙型肝炎病毒、巨细胞病毒、风疹病毒、支原体属、衣原体属、苍白密螺旋体、人类免疫缺陷病毒(HIV)感染,前3位分别细菌、乙型肝炎病毒、巨细胞病毒感染,感染率分别为42.39%、26.09%、13.04%;患者临床表现主要是末梢血白细胞>15×109/L、C-反应蛋白>8mg/L、孕妇心率与胎心明显加快及体温升高,胎儿结局为1例死胎、1例死产,90例新生儿中早产儿23例占25.00%、低体质儿26例占28.26%、先天畸形19例占20.65%;超声检查出1例HIV感染、5例风疹病毒感染及10例巨细胞病毒感染,出现异常声像图异常诊断率为17.39%。结论高龄产妇新生儿宫内感染以病毒感染为主,如不及时治疗,可导致胎儿畸形及不良后果,超声对于宫内感染的诊断有一定的局限性,检出率较低,因此,超声显示正常并不能说明有满意的妊娠结局。OBJECTIVE To analyze maternal age intrauterine infection types and clinical manifestations, the clinical value of ultrasonic diagnosis was discussed, so as to provide evidence to clinic. METHODS From Mar. 2010 to Mar. 2013 in our hospital, 92 cases of fetal given birth by advanced maternal were analyzed, all women underwent ultrasound examination, which diagnosis was discussed. RESULTS The causes of infections were by bacterial, hepatitis B virus, cytomegalovirus infection, rubella virus, mycoplasma, chlamydia, syphilis and HIV virus. The top three were bacterial, hepatitis B virus and cytomegalovirus infection, and infection rates were 42. 39%, 26.09 % and 13.04 %. Clinical manifestations of patients were peripheral blood WBC〉 15 ×10^9/L, CRP〉8 mg/ L, pregnant women significantly accelerated heart rate and fetal heart rate and body temperature raising. Among all the cases, one case was stillbirth, one case was dead-birth. A total of 90 newborn, preterm neonates 23 cases, accounting for 25%, low physical child 26 cases, accounting for 28.26%, congenital malformations in 19 cases, accounting for 20.65%. Ultrasound examination of one case had HIV infection, 5 cases of rubella virus infection and 10 cases of cytomegalovirus infection, and abnormal diagnosis was 17.39%. CONCLUSION Advanced maternal intrauterine infection with viral infection mainly, if not treated in time, can lead to fetal malformations and adverse consequences. Ultrasound for the diagnosis of intrauterine infection has some limitations, with low detection rate, therefore, normal ultrasound regult does not mean there is a satisfactory outcome of pregnancy.

关 键 词：高龄产妇 胎儿宫内感染 临床分析 超声诊断 

分 类 号：R181.32[医药卫生—流行病学]