产后发热的危险因素分析及临床管理策略探讨  

Analysis of Risk Factors and Clinical Management Strategies for Postpartum Fever

作　　者：张展 胡卫丽 Zhang Zhan;Hu Weili(Department of Obstetrics and Gynecology,The First People’s Hospital of Xiangfu District,Kaifeng,Henan,475100,China)

机构地区：[1]开封市祥符区第一人民医院妇产科,河南开封475100 [2]开封市祥符区第一人民医院外科,河南开封475100

出　　处：《黑龙江医学》2024年第20期2455-2458,共4页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关项目(LHGJ202101152)。

摘　　要：目的:分析产妇产后发热的危险因素,并探讨具体临床管理策略。方法:回顾性分析2020年8月—2023年3月开封市祥符区第一人民医院收治的95名待产产妇的临床资料,根据产后恢复情况,将40例产后发热患者列为病例组,55名正常分娩的产妇列为对照组。收集、对比两组产妇一般资料及临床资料,经单因素分析、logistic回归分析归纳导致产后发热的危险因素,结合分析结果提出针对性临床管理策略。结果:单因素分析结果显示,两组产妇的身体质量指数(BMI)、产次、妊娠期合并症、分娩方式等一般资料以及机体营养指标、血液指标、分娩情况、胎儿乳喂养情况等临床资料比较,差异均有统计学意义(χ^(2)=16.408、12.349、38.051、6.970、7.141、6.612、33.025、26.329、24.179、29.216、28.747、36.358、29.677、28.948、17.252,P<0.05)。logistic回归分析结果显示,BMI≥28 kg/m^(2)、经产妇、有妊娠期合并症、剖宫产、红蛋白(Hb)<100 g/L、血清白蛋白(ALB)<35 g/L、白细胞计数(WBC)≥15×10^(9)/L、中性粒细胞百分比(NE)≥70%、淋巴细胞百分比(LMY)≥40%、胎膜早破、胎盘残留、产后出血、羊水污染为产后发热的危险因素,产后纯母乳喂养为其保护因素(OR=5.325、5.244、5.229、6.325、5.314、5.336、5.281、5.339、5.772、6.033、6.255、6.274、5.258、6.125)。结论:产后发热与产妇肥胖、多次分娩、伴妊娠期合并症、剖宫产分娩、机体营养不良、伴感染症状、不良分娩结局以及非母乳喂养等多种因素密切相关,加强对产妇的围产期管理,优化分娩环境,提升医护人员临床治疗及护理水平是降低产后发热风险的重要举措。Objective:To analyze the risk factors of postpartum fever and explore specific clinical management strategies.Methods:Retrospective study was conducted on 95 expectant mothers included from August 2020 to March 2023.Based on postpartum recovery,40 postpartum fever patients were included in the case group and 55 normal postpartum women were included in the control group.General and clinical data were collected and compared between the two groups.Statistical univariate analysis and logistic regression analysis were used to identify the risk factors for postpartum fever,and propose targeted clinical management strategies based on the analysis results.Results:Results of statistical univariate analysis showed that there were certain differences in general data,such as BMI,parity,pregnancy complications,delivery method,as well as clinical data,such as body nutritional indicators,blood indicators,delivery status,and fetal milk feeding between the two groups of patients(χ^(2)=16.408,12.349,38.051,6.970,7.141,6.612,33.025,26.329,24.179,29.216,28.747,36.358,29.677,28.948,17.252;P<0.05).Logistc multivariate regression analysis showed that BMI≥28 kg/m^(2),multipara,pregnancy complications,caesarean section,Hb<100 g/L,ALB<35 g/L,WBC≥15×10^(9)/L,NE≥70%,LMY≥40%,premature rupture of membranes,placenta residue,postpartum bleeding,amniotic fluid pollution were the risk factors of postpartum fever,and postpartum pure breast feeding was the protective factor(OR=5.325,5.244,5.229,6.325,5.314,5.336,5.281,5.339,5.772,6.033,6.255,6.274,5.258,6.125).Conclusion:Postpartum fever is closely related to multiple factors,such as maternal obesity,multiple deliveries,complications during pregnancy,caesarean section delivery,malnutrition,infection symptoms,adverse delivery outcomes and non breast feeding.Strengthening perinatal management of pregnant women,optimizing the delivery environment,and improving the clinical treatment and nursing level of medical staff are important measures to reduce the risk of postpartum fever.

关 键 词：产后发热 危险因素 管理策略 

分 类 号：R714.46[医药卫生—妇产科学]