产时发热产妇所娩新生儿的不同抗生素使用疗程对比研究  

A comparative study on different antibiotic treatment courses used in hospitalized newborns delivered by mothers with intrapartum fever

作　　者：王晓康 韩兴旺 朱艳萍[1] Wang Xiaokang;Han Xingwang;Zhu Yanping(Department of Neonatology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011;School of Pediatrics,Xinjiang Medical University,Urumqi 830011)

机构地区：[1]新疆医科大学第一附属医院新生儿科,乌鲁木齐830011 [2]新疆医科大学儿科学院,乌鲁木齐830011

出　　处：《中国抗生素杂志》2025年第2期235-240,I0001,共7页Chinese Journal of Antibiotics

摘　　要：目的 了解产时发热产妇所生新生儿住院期间抗生素的使用情况,分析影响抗生素疗程长短的危险因素。方法 选择新疆医科大学第一附属医院2020年1月—2022年12月因母亲产时发热收住新生儿科的足月新生儿进行病例对照研究,根据抗生素使用天数将其分为短疗程组(≤3 d)及中长疗程组(>3 d),对比两组间影响抗生素疗程长短的临床危险因素及实验室检查指标(血常规及炎症因子)的差异,使用SPSS23.0统计软件进行统计学分析。结果 共纳入221例患儿,其中短疗程组53例,中长疗程组168例。中长疗程组新生儿出生后首次炎症因子指标高于短疗程组CRP14.15 mg/L(9.20, 20.75) vs7.90 mg/L(5.95, 14.05),PCT2.48 ng/mL (1.22, 4.85) vs 1.51 ng/mL (0.70, 2.84),差异均具有统计学意义(P<0.05);中长疗程组新生儿的第二次炎症因子指标高于短疗程组CRP 15.2 mg/L (11.20, 22.65) vs 8.2 mg/L (6.60, 10.60),PCT 1.6 ng/mL (0.75, 3.40) vs 0.99 ng/mL (0.49, 1.76),差异均具有统计学意义(P<0.05)。两组在新生儿出生后首次及第二次血检中WBC指标上差异均无统计学意义;中长疗程组新生儿的母亲发生羊水污染、确诊绒毛膜羊膜炎、发生胎膜早破比例高于短疗程组,差异均具有统计学意义(P<0.05)。经过Logistic回归分析显示:新生儿生后第二次CRP指标高(OR=1.178,95%CI 1.086~1.279,P<0.05)、产妇发生胎膜早破(OR=2.384,95%CI1.039~5.470,P<0.05)、产妇确诊绒毛膜羊膜炎(OR=3.344,95%CI1.503~7.438,P<0.05),是影响抗生素疗程长的独立危险因素。结论 临床中产妇胎膜早破、明确绒毛膜羊膜炎及新生儿生后第二次CRP升高会影响医生判断,延长抗生素的使用疗程。Objective To investigate the use of antibiotics in neonates born to mothers with intrapartum fever during hospitalization and to analyze the risk factors affecting the duration of antibiotic treatment.Methods The full-term neonates admitted to the neonatal department of the First Affiliated Hospital of Xinjiang Medical University due to maternal intrapartum fever from January 2020 to December 2022 were enrolled in a case-control study,and they were divided into short-term course groups(≤3 days)and medium-long course groups(>3 days)according to the number of days of antibiotic use.The differences between the two groups were compared in clinical risk factors and laboratory tests(blood counts and inflammatory factors),which were concerned as factors affecting the length of antibiotic course.Statistical software of SPSS version 23.0 was used for statistical analysis.Results A total of 221 children were enrolled,including 53 in the short-term course group and 168 in the medium-long course group.The first-time inflammatory factors in the medium-long course group were significantly higher than those in the short-term course group.Specifically,the CRP was 14.15 mg/L(9.20,20.75)compared to 7.90 mg/L(5.95,14.05),and the PCT was 2.48 ng/mL(1.22,4.85)compared to 1.51 ng/mL(0.70,2.84).The difference was statistically significant(P<0.05).The second-time inflammatory factors of newborns in the medium-long course group was higher than that of the short course group.The CRP was 15.2 mg/L(11.20,22.65)compared to 8.2 mg/L(6.60,10.60),and PCT was 1.6 ng/mL(0.75,3.40)compared to 0.99 ng/mL(0.49,1.76).The differences were statistically significant(P<0.05).However,there was no significant difference in WBC between the two groups in the first and second blood tests after birth.The proportions of amniotic fluid contamination,confirmed chorioamnionitis and premature rupture of membranes in the medium-long course group were higher than those in the short-term course group,and the differences were statistically significant(P<0.05).Logisti

关 键 词：产时发热 新生儿 抗生素使用 临床研究 

分 类 号：R978.1[医药卫生—药品]