论文部分内容阅读
目的:观察分析胎膜早破绒毛膜羊膜炎发生的影响因素及对新生儿预后的影响。方法:选择胎膜早破100例,将产后经胎盘组织病理学检查确认发生绒毛膜羊膜炎40例作为观察组,未发生绒毛膜羊膜炎60例作为对照组。比较两组临床资料及新生儿预后情况。结果:(1)观察组C反应蛋白(CRP)水平显著高于对照组(P<0.05),红细胞水平显著低于对照组(P<0.05),破膜至分娩时间显著长于对照组(P<0.05);两组白细胞计数、破膜孕周、血清清蛋白水平比较,均差异不显著(P>0.05)。体质指数(BMI)、破膜孕周、破膜至分娩时间、红细胞水平、人工流产史等因素,对胎膜早破绒毛膜羊膜炎的发生影响显著(P<0.05);产次和分娩方式对胎膜早破绒毛膜羊膜炎的发生影响不显著(P>0.05)。(2)以胎膜早破绒毛膜羊膜炎为因变量,对胎膜早破绒毛膜羊膜炎发生具有显著影响的相关指标为自变量,进行多因素Logistic回归分析,结果显示,破膜至分娩时间>48h、破膜孕周<32周、红细胞水平60~90g/L(中度贫血)、BMI≥26、有人工流产史等,进入以胎膜早破绒毛膜羊膜炎为因变量的回归方程(P<0.05)。(3)观察组新生儿娩出后1min Apgar评分、肺炎、病理性黄疸、窒息等发生率,均显著高于对照组(P<0.05);两组新生儿病死率差异不显著(P>0.05)。结论:破膜至分娩时间>48h、破膜孕周<32周、中度贫血、BMI≥26、有人工流产史,是胎膜早破绒毛膜羊膜炎发生的危险因素,绒毛膜羊膜炎对新生儿预后影响显著。
Objective: To observe and analyze the influencing factors of premature rupture of chorioamnionitis and prognosis of neonates. Methods: 100 cases of premature rupture of membranes were selected and 40 cases of chorioamnionitis confirmed by placental histopathology after birth were selected as the observation group. No chorioamnionitis occurred in 60 cases as the control group. The clinical data and prognosis of newborns were compared between the two groups. Results: (1) CRP level in observation group was significantly higher than that in control group (P <0.05), erythrocyte level was significantly lower than control group (P <0.05), and time from rupture of membrane to delivery was significantly longer than that of control group (P < 0.05). There was no significant difference between the two groups in white blood cell count, gestational weeks of rupture and serum albumin level (P> 0.05). Body mass index (BMI), rupture of membranes during pregnancy, rupture of membranes to delivery time, erythrocyte levels and abortion history had significant effects on the occurrence of chorioamnionitis (P <0.05) Premature rupture of membrane chorioamnionitis had no significant effect (P> 0.05). (2) According to multivariate logistic regression analysis, the related indicators that had a significant effect on premature rupture of chorioamnionitis were the dependent variable of premature rupture of membranes, and the results showed that rupture of membranes to delivery Time> 48h, rupture of membranes <32 weeks, erythrocyte level 60 ~ 90g / L (moderate anemia), BMI≥26, history of induced abortion, etc., entered the regression of premature rupture of membranes with chorioamnionitis as dependent variable Equation (P <0.05). (3) The incidences of Apgar score, pneumonia, pathological jaundice and asphyxia at 1 min after delivery in the observation group were significantly higher than those in the control group (P <0.05). There was no significant difference in neonatal mortality between the two groups (P> 0.05) . Conclusion: The time from rupture of membrane to delivery> 48h, gestational rupture of membrane <32 weeks, moderate anemia, BMI≥26, history of induced abortion is the risk factor of premature rupture of chorioamnionitis, chorioamnionitis The prognosis of newborns is significant.