微生态制剂联合抗生素对GBS阳性孕妇妊娠的影响
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摘要
目的观察微生态制剂联合抗生素对B族链球菌(Group B Streptococcus,GBS)阳性孕妇妊娠结局的影响。方法按纳入研究单双顺序,将本院284例GBS阳性孕妇分为微抗联合组(142例)和单抗生素组(142例)。分娩前,单抗生素组予以青霉素(500万单位/次,每周3次)静脉滴注,微抗联合组在单抗生素组基础上,给予益生菌(4粒/次,2次/d)。观察两组的妊娠结局、新生儿结局及新生儿脐血炎性指标差异。结果微抗联合组胎膜早破率、宫内感染率、早产率,新生儿窒息率、新生儿败血症率、新生儿脑膜炎率、新生儿黄疸率均低于单抗生素组,差异具有统计学意义(P <0.05);微抗联合组新生儿脐血的PCT、IL-6、CRP均低于单抗生素组,差异具有统计学意义(P<0.05)。结论微生态制剂联合抗生素预防治疗在改善GBS阳性产妇妊娠结局及婴儿结局上效果显著。
Objective To observe the effect of microecological agents combined with antibiotics on pregnancy outcome of group B Streptococcus(BGS) positive pregnant women. Methods 284 GBS-positive pregnant women in our hospital were divided into the combination group(142 cases) and the single antibiotic group(142 cases). Before delivery, penicillin(5 million units per time, 3 times a week) was given intravenously in the single antibiotic group. On the basis of single antibiotic group, probiotics(4 capsules per time, 2 times per day) were given in the combined group. The difference of pregnancy outcome, neonatal outcome and neonatal cord blood inflammatory index between the two groups was observed. Results Premature rupture of membranes, intrauterine infection rate, premature delivery rate,neonatal asphyxia rate, neonatal sepsis rate, neonatal meningitis rate and neonatal jaundice rate in the combined group were lower than those in the single antibiotic group, with statistical significance(P < 0.05). The levels of CT, IL-6 and CRP in umbilical cord blood of neonates in the combination group were lower than those in the single antibiotic group,and the difference was statistically significant(P < 0.05). Conclusion Microecological agents combined with antibiotic prophylaxis are effective in improving pregnancy outcome and infant outcome of GBS positive puerpera.
Objective To observe the effect of microecological agents combined with antibiotics on pregnancy outcome of group B Streptococcus(BGS) positive pregnant women. Methods 284 GBS-positive pregnant women in our hospital were divided into the combination group(142 cases) and the single antibiotic group(142 cases). Before delivery, penicillin(5 million units per time, 3 times a week) was given intravenously in the single antibiotic group. On the basis of single antibiotic group, probiotics(4 capsules per time, 2 times per day) were given in the combined group. The difference of pregnancy outcome, neonatal outcome and neonatal cord blood inflammatory index between the two groups was observed. Results Premature rupture of membranes, intrauterine infection rate, premature delivery rate,neonatal asphyxia rate, neonatal sepsis rate, neonatal meningitis rate and neonatal jaundice rate in the combined group were lower than those in the single antibiotic group, with statistical significance(P < 0.05). The levels of CT, IL-6 and CRP in umbilical cord blood of neonates in the combination group were lower than those in the single antibiotic group,and the difference was statistically significant(P < 0.05). Conclusion Microecological agents combined with antibiotic prophylaxis are effective in improving pregnancy outcome and infant outcome of GBS positive puerpera.
引文
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[4]Duochun LV,Chen CY,Wang JJ,et al.Molecular characteristics and antimicrobial resistance in invasive and noninvasive Group B Streptococcus between 2008 and 2015 in China[J].Diagnostic Microbiology&Infectious Disease,2016,86(4):749-756.
[5]张宇,陈航华,贺青蓉,等.妊娠晚期孕妇B族链球菌带菌情况及干预对妊娠结局的影响[J].检验医学与临床,2018,15(13):1974-1977.
[6]杨敏.卡贝缩宫素应用于疤痕子宫剖宫产术中的疗效[J].中西医结合心血管病电子杂志,2018,6(20):194.
[7]韩玉红.剖宫产手术中缩宫素不同给药方式的临床应用效果[J].健康研究,2018,38(3):352-353..
[8]方恋,龚泽龙,林岱华,等.口服微生态制剂对孕妇肠道和阴道大肠杆菌K1和B族链球菌定殖的干预[J].微生物学报,2018,58(11):1989-1996.
[9]龚春竹,程昕然.金双歧预防早期新生儿高胆红素血症的临床观察[J].中国微生态学杂志,2018,30(3):317-319.
[10]蔡琴.足月胎膜早破孕妇阴道微生态及B族链球菌感染情况与母儿结局的关系分析[D].重庆:重庆医科大学,2016:10-11.
[11]Julie BR,Noha GR,Clémence GD,et al.Activation of the IL-1β/CXCL1/MMP-10 axis in chorioamnionitis induced by inactivated Group B Streptococcus[J].Placenta,2016,47(13):489-496.