高龄初产妇剖宫产术后并发产褥感染的病原菌分布和危险因素分析  

Analysis of Pathogenic Bacteria Distribution and Risk Factors of Elderly Primiparous Women Complicated by Puerperal Infection afteRCesarean Section

作　　者：刘梅香[1] LIU Mei-xiang(Suichuan County Maternal and Child Health Hospital,Ji'an Jiangxi 343900,China)

机构地区：[1]遂川县妇幼保健院,江西吉安343900

出　　处：《抗感染药学》2023年第6期616-620,共5页Anti-infection Pharmacy

摘　　要：目的:探究医院高龄初产妇剖宫产术后并发产褥感染的病原菌分布和危险因素,为此类人群产褥感染的防治提供参考。方法:选取2018年1月—2023年1月遂川县妇幼保健院收治的352例行剖宫产的高龄初产妇作为研究对象,根据其术后是否并发产褥感染将其分为感染组(n=29)与未感染组(n=323),采集所有产妇的年龄、身高、体质量、学历、并发症、用药史、孕周、手术时间、产后出血、胎膜早破、实验室检查结果等信息,分析其术后并发产褥感染的病原菌分布和危险因素。结果:29例并发产褥感染产妇标本中共检出病原菌92株,其中革兰阴性菌64株(占69.57%,以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌为主)、革兰阳性菌28株(占30.43%,以链球菌为主);回归分析结果显示,高龄初产妇剖宫术后发生产褥感染与产前血红蛋白水平、产前生殖道感染与否、手术时间、产后出血与否、合并糖尿病与否、胎膜早破与否具有相关性(P<0.05),其中产前血红蛋白水平<60 g/L、有产前生殖道感染、手术时间≥1.5 h、存在产后出血、合并糖尿病、发生胎膜早破是产妇术后发生产褥感染的独立危险因素(P<0.05)。结论:产前血红蛋白水平、产前生殖道感染、手术时间、产后出血、合并糖尿病、胎膜早破是高龄产妇剖宫产术后发生产褥感染的重要影响因素,临床对具有高危因素的产妇应当加强护理和监测,以避免和减少产褥感染的发生,从而确保母婴的健康。Objective:To explore the pathogenic bacteria distribution and risk factors of elderly primiparous women complicated by puerperal infection afteRcesarean section in the hospital,so as to provide reference foRthe prevention and treatment of puerperal infection in such population.Methods:352 elderly primiparous women who were admitted to Suichuan County Maternal and Child Health Hospital and underwent cesarean section from January 2018 to January 2023 were selected as the research objects,and they were divided into the infected group(n=29)and the uninfected group(n=323)according to the presence oRabsence of puerperal infection afteRsurgery.Information of all parturients such as age,height,weight,education,complications,medication history,gestational age,operation time,postpartum hemorrhage,premature rupture of membranes,and laboratory test results was collected to analyze the pathogenic bacteria distribution and risk factors of them complicated by puerperal infection afteRsurgery.Results:A total of 92 strains of pathogenic bacteria were detected in 29 samples of parturients complicated by puerperal infection,including 64 strains of Gram-negative bacteria(69.57%,mainly Escherichia coli,Pseudomonas aeruginosa,and Klebsiella pneumoniae),and 28 strains of Gram-positive bacteria(30.43%,mainly Streptococcus);the regression analysis results showed that the occurrence of puerperal infection in elderly primiparous women afteRcesarean section was related to prenatal hemoglobin level,presence of prenatal reproductive tract infection,operation time,postpartum hemorrhage or not,combined diabetes oRnot,and premature rupture of membranes oRnot(P<0.05);among them,prenatal hemoglobin level less than 60 g/L,presence of prenatal reproductive tract infection,operation time longeRthan oRequal to 1.5 h,presence of postpartum hemorrhage,combined diabetes,and occurrence of premature rupture of membranes were independent risk factors foRpuerperal infection afteRsurgery(P<0.05).Conclusion:Prenatal hemoglobin level,prenatal reproductive tract

关 键 词：高龄初产妇 剖宫产 产褥感染 危险因素 病原学特点 

分 类 号：R181.32[医药卫生—流行病学]