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目的探讨初产妇发生产褥感染的相关影响因素。方法选择80例产褥感染初产妇为观察组,160例未发生产褥感染的初产妇为对照组,分析发生产褥感染初产妇的感染部位及病原菌分布情况,比较两组产妇的一般资料,并多因素Logistic回归分析产褥感染的相关影响因素。结果观察组初产妇手术切口感染17例,会阴部感染35例,无脓毒血症以及败血症等全身性感染患者;共有89株病原菌被分离出,其中大肠埃希菌最多26株(29.21%)。两组初产妇年龄、孕周、会阴侧切、多胎妊娠、剖宫产差异无统计学意义(P>0.05),产钳/胎头吸引助产率以及合并症发生率等差异有统计学意义(P<0.05)。多因素Logistic回归分析发现,产褥感染与多胎妊娠、产钳/胎头吸引、合并症关系明显(P<0.05),而与患者的孕周、年龄、剖宫产率以及会阴侧切等无关(P>0.05)。结论初产妇产褥感染以手术切口、会阴部及宫内(子宫肌层及子宫内膜)感染为主,主要与多胎妊娠、产钳/胎头吸引、合并症等因素相关。
Objective To investigate the influencing factors of puerperal infection in primipara. Methods 80 primiparous women with puerperal infection were selected as the observation group and 160 primipara without puerperal infection as the control group. The infection sites and pathogenic bacteria distribution of primipara occurred in puerperal infection were analyzed. The general data of the two groups were compared. Logistic regression analysis was used to analyze the influencing factors of puerperal infection. Results In the observation group, 17 cases were infected by incision of primipara, 35 cases were infected by perineum, sepsis and sepsis. A total of 89 strains of pathogens were isolated, of which 26 strains were Escherichia coli (29.21%), . There was no significant difference between the two groups in primiparae age, gestational age, episiotomy, multiple pregnancy and cesarean section (P> 0.05), and the rate of obstetric forceps and fetal distraction were significantly different (P <0.05). Multivariate Logistic regression analysis showed that the relationship between puerperal infection and multiple pregnancy, forceps / fetal head attraction and comorbidity was significant (P <0.05), but not related to gestational age, age, cesarean section rate and episiotomy > 0.05). Conclusion The primiparous puerperal infection was mainly associated with surgical incision, perineal and intrauterine (myometrium and endometrium) infection, mainly related to multiple pregnancy, forceps / fetal head attraction and comorbidities.