妊娠期单核细胞增生李斯特菌感染孕妇临床特点分析  

Clinical features analysis of pregnant women with Listeria monocytogenes infection

作　　者：姜慧[1] 杨咏梅[1] JIANG Hui;YANG Yongmei(Xuanwu Hospital,Capital Medical University,Beijing,100053)

机构地区：[1]首都医科大学宣武医院,北京100053

出　　处：《中国计划生育学杂志》2021年第3期568-571,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨妊娠期单核细胞增生李斯特菌(LM)感染孕妇临床特点及妊娠结局。方法:回顾性收集2016年—2018年本院收治的妊娠期LM感染的7例孕妇临床资料,分析临床特征、实验室确诊依据、抗生素药物治疗、妊娠结局。结果:7例平均年龄27.1岁,平均孕周25.6周;1例(病例3)治愈出院,6例胎死宫内;7例就诊时有6例表现为发热与胎动异常,高热4例,中等1例,有1例不发热;病例3白细胞计数、C反应蛋白水平低于另外6例,羊水污染为Ⅰ度,其他6例为Ⅲ度,采集的羊水与血液标本经LM培养均阳性;7例均未发生胎膜早破。胎盘组织病理学检查,1例因医师经验不足未行,余6例均提示急性绒毛膜羊膜炎,其中1例同时提示急性脐带炎;1例治愈孕妇出院前2天体温恢复正常,6例胎死宫内;7例中产后感染1例,产后当天体温恢复正常4例,产后2天体温恢复正常2例;主要治疗药物为阿莫西林、头孢类及美罗培南。结论:妊娠期LM感染孕妇临床特点以胃肠道反应、感冒样症状、胎动异常表现为主,主要采用抗生素药物治疗,该病菌感染对孕妇危害不大但易造成胎儿死亡。Objective:To investigate the clinical features and pregnancy outcomes of pregnant women with Listeria monocytogenes(LM)infection during pregnancy.Methods:The clinical data of 7 pregnant women with LM infection during pregnancy from 2016 to 2018 were retrospectively analyzed.The clinical characteristics,laboratory diagnosis basis,antibiotic treatment,drug resistance,fetal condition,and pregnancy outcomes of the 7 pregnant women were analyzed.Results:The average age of these 7 pregnant women was 27.14 years old,and their average gestational week was 25.64 weeks.1 pregnant woman(No.3 pregnant woman)was cured and discharged,and the remaining 6 fetus died in uterus.Among the 7 women,6(85.71%)women had fever and abnormal fetal movement.Among the 7 women,there were 4 women with high fever(1 woman with moderate fever),and 1 woman without fever.The white blood cell count and C-reactive protein level of No.3 pregnant woman with amniotic fluid pollution grade I were lower than those of other 6 pregnant women with amniotic fluid pollution degreeⅢ.The samples from amniotic fluid and blood after LM culture all showed positive results.There was no any woman with premature rupture of fetal membranes in the 7 women.Only 1 case did not undergo histopathological examination due to inexperienced clinician,while the other 6 women had acute chorioamnionitis after histopathological examination,and among them,1 woman had also acute omphalitis during the same time.The temperature of that discharged pregnant women returned to normal 2 days before discharge.There were 6 pregnant women with fetal death.There was 1 woman with postpartum infection in the 7 women.In the7 women,the body temperature of 4 cases returned to normal on the day of postpartum,and the body temperature of 2 cases returned to normal on the second day after delivery.The main treatment drugs were amoxicillin,cephalosporins,and meropenem.Conclusion:The clinical features of pregnant women with LM infection during pregnancy are mainly gastrointestinal reaction,cold like sym

关 键 词：妊娠期 单核细胞增生李斯特菌 临床特征 抗生素治疗 妊娠结局 

分 类 号：R714.251[医药卫生—妇产科学]