宫内感染对新生儿窒息的风险评估
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摘要
目的评估宫内感染对新生儿窒息的风险。方法方便选取该院2015年1月—2017年6月诊断为宫内感染的130例患者进行资料分析,对患者宫内感染的实验室检查结果、临床表现、诊断时间点、破膜情况、分娩方式、病原菌分布及新生儿窒息情况进行分析。结果宫内感染产妇的临床表现有羊水臭味、子宫体压痛、脉搏、体温、胎心率升高,血C反应蛋白(CRP)及白细胞(WBC)数目明显增加等。入院时诊断为宫内感染的患者占20.0%(26/130),保胎期占13.1%(17/130),引产中占45.4%(59/130),产程中占21.5%(28/130)。破膜方式为胎膜早破占40.0%(52/130),人工破膜占42.3%(55/130),胎膜自破占13.1%(17/130),胎膜未破占4.6%(6/130)。所有患者中剖宫产占74.6%(97/130),顺产占25.4%(33/130)。宫腔培养发现,主要的病原菌为B族链球菌、粪肠球菌、金黄葡萄球菌、李斯特菌等。新生儿窒息的发生率为22.3%(29/130),其中早产儿窒息发生率15.7%(16/102)明显高于顺产儿(χ~2=11.980,P=0.001)。结论宫内感染患者羊水等存在着明显异常,宫内感染对母婴造成严重影响,导致了新生儿窒息发生率增加,并且在早产儿中发生更加严重。
Objective To assess the risk of intrauterine infection for neonatal asphyxia. Methods A total of 130 patients diagnosed with intrauterine infection from January 2015 to June 2017 in our hospital were convenient selected for data analysis. Laboratory results, clinical manifestations, time points of diagnosis, membrane rupture, and mode of delivery of intrauterine infection, pathogen distribution and neonatal asphyxia were analyzed. Results The clinical manifestations of intrauterine infection were amniotic fluid odor, uterine tenderness, pulse, body temperature, fetal heart rate, blood C-reactive protein(CRP) and white blood cell(WBC). 20.0%(26/130) of patients diagnosed with intrauterine infection at admission,13.1%(17/130) of the miscarriage period, 45.4%(59/130) of induction labor, and 21.5% of labor(28/130). The rupture of membranes accounted for 40.0%(52/130) of premature rupture of membranes, 42.3%(55/130) of artificial membranes,13.1%(17/130) of membranes, and 4.6%(6/130) of membranes. Catheter production accounted for 74.6%(97/130) of all patients, and 25.4%(33/130) of cesarean section. In the uterine cavity culture, the main pathogens were group B streptococcus, Enterococcus faecalis, Staphylococcus aureus, Listeria. The incidence of neonatal asphyxia was 22.3%(29/130), and the prevalence of asphyxia in preterm infants was 15.7%(16/102), which was significantly higher than that in children(χ~2=11.980, P=0.001). Conclusion There are obvious abnormalities in amniotic fluid in patients with intrauterine infection. Intrauterine infection has a serious impact on mother and infant, which leads to an increase in the incidence of neonatal asphyxia and is more serious in premature infants.
Objective To assess the risk of intrauterine infection for neonatal asphyxia. Methods A total of 130 patients diagnosed with intrauterine infection from January 2015 to June 2017 in our hospital were convenient selected for data analysis. Laboratory results, clinical manifestations, time points of diagnosis, membrane rupture, and mode of delivery of intrauterine infection, pathogen distribution and neonatal asphyxia were analyzed. Results The clinical manifestations of intrauterine infection were amniotic fluid odor, uterine tenderness, pulse, body temperature, fetal heart rate, blood C-reactive protein(CRP) and white blood cell(WBC). 20.0%(26/130) of patients diagnosed with intrauterine infection at admission,13.1%(17/130) of the miscarriage period, 45.4%(59/130) of induction labor, and 21.5% of labor(28/130). The rupture of membranes accounted for 40.0%(52/130) of premature rupture of membranes, 42.3%(55/130) of artificial membranes,13.1%(17/130) of membranes, and 4.6%(6/130) of membranes. Catheter production accounted for 74.6%(97/130) of all patients, and 25.4%(33/130) of cesarean section. In the uterine cavity culture, the main pathogens were group B streptococcus, Enterococcus faecalis, Staphylococcus aureus, Listeria. The incidence of neonatal asphyxia was 22.3%(29/130), and the prevalence of asphyxia in preterm infants was 15.7%(16/102), which was significantly higher than that in children(χ~2=11.980, P=0.001). Conclusion There are obvious abnormalities in amniotic fluid in patients with intrauterine infection. Intrauterine infection has a serious impact on mother and infant, which leads to an increase in the incidence of neonatal asphyxia and is more serious in premature infants.
引文
[1]栗娜,郑东明,庄艳艳,等.双胎妊娠分娩时机与新生儿窒息关系研究[J].中国实用妇科与产科杂志,2016,32(3):276-279.
[2]冯娟,罗萍,陈惠丽,等.产后宫内感染的影响因素及病原菌分析[J].中华医院感染学杂志,2017,27(17):3986-3988.
[3]刘玉凤,蔡江云,史春,等.宫内感染与早产儿脑损伤的关系研究[J].中华医院感染学杂志,2016,26(13):3109-3111.
[4]吴丽群,王美霞,姚锐,等.宫内感染与胎母输血综合征的细胞因子变化及围产儿预后[J].实用医学杂志,2017,33(18)3085-3088.
[5]何颖.胎膜早破后残余羊水量对孕妇宫内感染及妊娠结局的影响[J].中国妇幼保健,2017,32(8):1630-1632.
[6]吴璠,华绍芳,李月琴.早产胎膜早破患者发生新生儿宫内感染性肺炎的相关因素分析[J].中国妇幼保健,2016,31(21)4472-4475.
[7]梁格凤.新生儿窒息的危险因素分析与护理管理[J].中外医学研究,2017,15(4):97-98.
[8]马赛芬.新生儿窒息的危险因素分析与护理对策[J].深圳中西医结合杂志,2016,26(4):183-184.
[9]蔡群,雷厚康,胡芳,等.孕妇孕期宫内感染相关因素研究[J]中华医院感染学杂志,2015,25(18):4273-4275.
[10]刘静,曲红明.2009-2014年南京市新生儿死亡情况分析[J]现代预防医学,2015,42(22):4081-4083.
[11]Wu B,Paediatrics D O.Clinical Analysis of Neonatal Pulm onary Hemorrhage with Intrauterine infection[J].Contempor ary Medicine,2018,5(1):4-5.
[12]Li Y,Liao D,Meng D,et al.Analysis of risk factors of invasive fungal infection in n ewborns[J].Chinese Journal of Obstetrics&Gynecology&Pediatrics,2016,2(8):42-43.
[13]Liu S,Zhang C,Zhang Y,et al.Analysis of risk factors for neonatal brain injury[J].Acta Academiae Medicinae Weifa ng,2018,12(3):5-6.
[14]余娜,申健.149例新生儿窒息相关因素临床分析及预防对策[J].中国生育健康杂志,2013,24(3):1962.
[15]Zhao Y H.Effect of comprehensive nursing intervention on intrauterine infection and neonatal outcome of maternal premature rupture of membranes[J].Cardiovascular Disease Journal of Integrated Traditional Chinese&Western Medic ine,2016,2(1):27-28.
[16]Jin-Rong Y U,Neonatology D O.Influencing factors and preventive effect of neonatal asphyxia in 150 cases[J].Maternal&Child Health Care of China,2018,2(1):4-6.
[2]冯娟,罗萍,陈惠丽,等.产后宫内感染的影响因素及病原菌分析[J].中华医院感染学杂志,2017,27(17):3986-3988.
[3]刘玉凤,蔡江云,史春,等.宫内感染与早产儿脑损伤的关系研究[J].中华医院感染学杂志,2016,26(13):3109-3111.
[4]吴丽群,王美霞,姚锐,等.宫内感染与胎母输血综合征的细胞因子变化及围产儿预后[J].实用医学杂志,2017,33(18)3085-3088.
[5]何颖.胎膜早破后残余羊水量对孕妇宫内感染及妊娠结局的影响[J].中国妇幼保健,2017,32(8):1630-1632.
[6]吴璠,华绍芳,李月琴.早产胎膜早破患者发生新生儿宫内感染性肺炎的相关因素分析[J].中国妇幼保健,2016,31(21)4472-4475.
[7]梁格凤.新生儿窒息的危险因素分析与护理管理[J].中外医学研究,2017,15(4):97-98.
[8]马赛芬.新生儿窒息的危险因素分析与护理对策[J].深圳中西医结合杂志,2016,26(4):183-184.
[9]蔡群,雷厚康,胡芳,等.孕妇孕期宫内感染相关因素研究[J]中华医院感染学杂志,2015,25(18):4273-4275.
[10]刘静,曲红明.2009-2014年南京市新生儿死亡情况分析[J]现代预防医学,2015,42(22):4081-4083.
[11]Wu B,Paediatrics D O.Clinical Analysis of Neonatal Pulm onary Hemorrhage with Intrauterine infection[J].Contempor ary Medicine,2018,5(1):4-5.
[12]Li Y,Liao D,Meng D,et al.Analysis of risk factors of invasive fungal infection in n ewborns[J].Chinese Journal of Obstetrics&Gynecology&Pediatrics,2016,2(8):42-43.
[13]Liu S,Zhang C,Zhang Y,et al.Analysis of risk factors for neonatal brain injury[J].Acta Academiae Medicinae Weifa ng,2018,12(3):5-6.
[14]余娜,申健.149例新生儿窒息相关因素临床分析及预防对策[J].中国生育健康杂志,2013,24(3):1962.
[15]Zhao Y H.Effect of comprehensive nursing intervention on intrauterine infection and neonatal outcome of maternal premature rupture of membranes[J].Cardiovascular Disease Journal of Integrated Traditional Chinese&Western Medic ine,2016,2(1):27-28.
[16]Jin-Rong Y U,Neonatology D O.Influencing factors and preventive effect of neonatal asphyxia in 150 cases[J].Maternal&Child Health Care of China,2018,2(1):4-6.