胎膜早破产妇分娩的新生儿感染情况及综合护理干预效果  

Influential factors of neonatal infection in maternal fetal premature delivery and comprehensive nursing intervention

作　　者：李海莲[1] 黄丽霞[1] 储丽敏[2] 李海香 赵明霞 LI Hai-lian;HUANG Li-xia;CHU Li-min;LI Hai-xiang;ZHAO Ming-xia(The First Hospital of Hebei Medical University,Shijiazhuang,Hebei 050031,China)

机构地区：[1]河北医科大学第一医院产科,河北石家庄050031 [2]河北医科大学第一医院儿科,河北石家庄050031 [3]榆林市第二医院妇产科,陕西榆林719000

出　　处：《中华医院感染学杂志》2018年第17期2673-2676,共4页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究基金资助项目(20170528)

摘　　要：目的探讨胎膜早破(premature rupture of membranes,PROM)产妇分娩的新生儿感染情况及综合护理干预效果。方法回顾性分析2014年3月-2016年1月病例资料齐全的708例胎膜早破产妇的临床资料,观察新生儿感染情况,调查新生儿感染的相关因素;另选取2016年3月-2017年4月收治的胎膜早破产妇122例,随机分为护理A组和B组,各61例,A组针对胎膜早破产妇分娩风险因素进行针对性、综合护理干预,B组61仅实施常规护理干预,比较两组护理效果。结果 708例PROM产妇分娩的新生儿感染率为4.38%(31/708);PROM病程>48h的新生儿感染风险最高,随着PROM病程的增长新生儿感染率也将增长,各PROM病程阶段感染风险对比差异性明显(P<0.05),28~32孕周PROM产妇发生新生儿感染风险最高,各PROM病程阶段感染率差异有统计学意义(P<0.05)。护理A组PROM产妇破膜临产延长时间为(45.39±14.32)d长于护理B组(P<0.001);护理A组PROM产妇产后出血量为(317.68±31.85)ml和宫内感染率4.92%(3/61)与护理B组比较,差异有统计学意义(P<0.001)。护理A组阿氏评分(Apgar)评分、出生体质量分别为(9.38±0.21)分、(3.41±0.27)kg高于护理B组(P<0.001);护理A组新生儿窒息、胎儿窘迫发生率分别为1.64%(1/61)、4.92%(3/61)低于护理B组(P<0.001)。结论胎膜早破病程延长可造成新生儿感染率上升,及时的综合干预护理则能够抑制宫缩,增加胎肺成熟率,减少感染率,改善分娩结局。OBJECTIVE To study the influencing factors of neonatal infection in maternal premature rupture of membranes,and to summarize the effect of comprehensive nursing intervention.METHODS 708 cases of maternal premature rupture of membranes were recorded from Mar.2014 to Jan.2016 in the hospital.The neonatal infection was observed and the high-risk factors were investigated.In addition,a total of 122 cases of premature rupture of membranes were collected by prospective study from Mar.to Apr.2017 and were randomly divided into two groups：group A（n=61 cases）was treated with targeted,comprehensive nursing intervention according to the risk factors of maternal premature rupture of membranes,and group B（n=61 cases）was only treated with the routine nursing intervention.The nursing effects of the two groups were compared.RESULTS The neonatal infection rate of 708 cases of PROM maternal delivery was 4.38%（31/708）.The infection risk of newborns with a PROM course〉48 hwas the highest.With the increase of PROM course,the neonatal infection rate also increased.The infection risk of each PROM stage was significantly different（P〈0.05）.The risk of neonatal infection for those with 28 to 32 weeks of gestation was the highest,and the difference in the infection risk of each PROM stage was significant（P〈0.05）.The prolonged duration of rupture of membranes in group A was（45.39±14.32）d longer than that of group B（P〈0.001）.The postpartum hemorrhage of group A was（317.68±31.85）ml and the rate of intrauterine infection was 4.92%（3/61）.Compared with group B,the difference was statistically（P〈0.05）.The Apgar score and birth weight of group A were（9.38±0.21）and（3.41±0.27）kg,higher than those of group B（P〈0.05）.Neonatal asphyxia and fetal distress occurred in group A.The rates were 1.64%（1/61）and 4.92%（3/61）,significantly lower than those in group B（P〈0.05）.CONCLUSION The prolongation of the pathogenesis of premature rupture of membranes can significantly increas

关 键 词：胎膜早破 新生儿感染 影响因素 综合护理 干预效果 

分 类 号：R473.71[医药卫生—护理学]