抗感染干预对孕妇生殖道B族链球菌感染胎膜早破的影响  

Effect of anti-infection intervention on premature rupture of fetal membranes induced by group B Streptococcusinfection in pregnant women

作　　者：张莹[1] 孙晖[2] 王英[3] 郭清普[1] 赵会珍[1] 

机构地区：[1]郑州大学附属医院南阳市中心医院消毒供应中心二部,河南南阳473000 [2]郑州大学附属医院南阳市中心医院妇二科,河南南阳473000 [3]郑州大学附属医院南阳市中心医院妇三科,河南南阳473000

出　　处：《中华医院感染学杂志》2017年第1期179-181,211,共4页Chinese Journal of Nosocomiology

基　　金：河南省杰出人才创新基金资助项目(0524157309)

摘　　要：目的探讨抗感染干预对孕妇生殖道B族链球菌(GBS)感染胎膜早破及对母婴预后的影响,以期为临床提供数据依据。方法选取2014年1月-2015年12月医院感染GBS的待分娩孕妇100例,随机单盲取法分为A、B组,另选同期未感染GBS孕妇50例为C组,A、B组均进行药敏试验,以观察当地GBS耐药性;A组选择药敏中敏感药物进行抗感染治疗至分娩,B、C组不予治疗;观察药敏试验结果,不同组别新生儿体质量、Apgar评分及母婴结局。结果 A、B组100例孕妇中对青霉素、克林霉素敏感率均>90.00%,A组50例孕妇采用青霉素抗感染治疗,其余13例为青霉素过敏孕妇,采用克林霉素抗感染治疗;三组新生儿体质量比较,差异无统计学意义,B组新生儿1min及5min Apgar低于A、C组(P<0.05);三组产妇产褥感染、宫内感染、羊水污染、产后出血发生率比较,差异无统计学意义;B组胎膜早破、剖宫产发生率高于A、C组(P<0.05);三组新生儿胎儿窘迫、早产发生率比较,差异无统计学意义,B组新生儿肺炎及窒息发生率高于A、C组(P<0.05)。结论孕妇生殖道GBS可增加胎膜早破、母婴不良结局,通过抗感染治疗,可降低胎膜早破发生率,改善母婴不良结局。OBJECTIVE To explore the effect of anti-infection intervention on premature rupture of fetal membranes induced by group B Streptococcus （GBS） infection in pregnant women and on prognosis of mother and infant so as to provide the clinical data. METHODS A total of 100 pregnant women with GBS infection who were going to give birth from Jan 2014 to Dec 2015 were enrolled in the study and divided into the group A and B by using randomized single blind method, meanwhile, 50 pregnant women without GBS infection were assigned as the group C, the drug susceptibility testing was performed for the group A and B so as to observe the drug resistance of the GBS isolated from the local area. The group A was treated with sensitive antibiotics that were chosen based on the result of drug susceptibility testing till the delivery, the group B and C were not given any treatment. The results of the drug susceptibly testing were observed~ the body mass of neonates, Apgar score, and outcomes of mother and in- fant were compared among the three groups. RESULTS Among the 100 pregnant women in the group A and B, the drug susceptibility rates to penicillin and clindamycin were more than 90.00% ; the 50 patients in the group A were treated with penicillin, the rest of 13 pregnant women were allergy to penicillin and treated with clindamycin. There was no significant difference in the body mass of neonates among the three groups. The 1 min and 5 rain Ap- gar scores of neonates were lower in the group B than in the group A and C （P〈0.05）. There was no significant difference in the incidence of puerperal infection, intrauterine infection, contamination of amniotic fluid, or post- partum hemorrhage among the three groups of pregnant women. The incidence rates of premature rupture of fetal membranes and cesarean section were higher in the group B than in the group A and C （P〈0. 05）. There was no significant difference in the incidence of fetal distress or premature delivery of neonates among the three groups; the incidence rates

关 键 词：抗感染 孕妇 生殖道B族链球菌感染 胎膜早破 母婴结局 

分 类 号：R714.433[医药卫生—妇产科学]