高龄剖宫产后并发产褥感染的危险因素及血清细胞因子检测的临床意义  

Risk factors of puerperal infection and clinical significance of serum cytokine detection in the older mothers after cesarean section

作　　者：郑芳 钟洁 宋丹 ZHENG Fang;ZHONG Jie;SONG Dan(Operating Room,Shaoxing Yuecheng Peopled Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市越城区人民医院手术室,浙江绍兴312000

出　　处：《健康研究》2022年第6期700-704,共5页Health Research

摘　　要：目的 探讨高龄剖宫产后并发产褥感染的危险因素及血清细胞因子检测的临床意义。方法 回顾860例接受剖宫产术的高龄产妇临床资料,分析剖宫产并发产褥感染的相关危险因素,比较是否发生产褥感染的产妇血清相关炎症因子水平,采用受试者工作特征曲线(ROC)评价相关指标对剖宫产产妇产褥感染的诊断价值。结果 剖宫产的高龄产妇并发产褥感染60例,产妇产褥感染率为6.98%;多因素Logistic回归分析显示,合并糖尿病和术中出血量≥500 mL是术后并发产褥感染的独立危险因素(P<0.05)。感染组产妇血清PCT、IFN-γ、TGF-β、CRP水平均高于非感染组,差异有统计学意义(P<0.05);血清PCT、IFN-γ、TGF-β、CRP联合诊断产妇产褥感染的曲线下面积(AUC)最高。结论 合并糖尿病和术中出血量≥500 mL的高龄剖宫产产妇更易发生产褥感染,临床可根据血清PCT、IFN-γ、TGF-β、CRP水平变化预测产褥感染的发生。Objective To explore the risk factors of puerperal infection and the clinical significance of serum cytokine detection after cesarean section in the older mothers. Methods The clinical data of 860 older mothers undergoing cesarean section were reviewed. The risk factors of cesarean section complicated with puerperal infection were analyzed. The levels of related serum inflammatory factors were compared between the parturient with puerperal infection and those without puerperal infection. The diagnostic values of related indicators for puerperal infection of parturient after cesarean section were evaluated using the receiver operating characteristic curve(ROC). Results There were 60 cases of puerperal infection in the older mothers after cesarean section, and the puerperal infection rate was 6.98%. Multivariate Logistic regression analysis showed that diabetes and intraoperative bleeding≥500 mL were independent risk factors for puerperal infection after operation(P<0.05). The serum levels of PCT, IFN-γ, TGF-β, and CRP of parturientin theinfection group were higher than those in the non-infection group, and the difference was statistically significant(P<0.05). The area under the curve(AUC) of serum PCT, IFN-γ, TGF-β, and CRP combined diagnosis of puerperal infection was the highest. Conclusions The older mothers after cesarean section with diabetes and intraoperative bleeding≥500 mL were more likely to suffer from puerperal infection. According to changes of serum PCT, IFN-γ, TGF-β, and CRP levels, the occurrence of puerperal infection can be predicted.

关 键 词：高龄产妇 剖宫产 产褥感染 危险因素 细胞因子 

分 类 号：R714.62[医药卫生—妇产科学]