妊娠未足月胎膜早破临床诊治相关因素分析_临床医学论文.docVIP

妊娠未足月胎膜早破临床诊治相关因素分析_临床医学论文 妊娠未足月胎膜早破临床诊治相关因素分析_临床医学论文 【摘要】 目的 探讨未足月胎膜早破的妊娠结局及临床处理。方法 对南方医科大学附属花都医院2005年3月至2008年12月收治的124例未足月胎膜早破患者(其中孕28～33+6周26例为A组;孕34～36+6周98例为B组)的临床资料进行回顾性对照分析。同时随机抽取同期住院妊娠足月无胎膜早破者248例作为对照组进行比较。结果 孕28～33+6周与孕34～36+6周未足月胎膜早破母亲产褥感染、产后出血、分娩方式的比较，差异无统计学意义(Pgt;0.05)。未足月胎膜早破组产后出血与足月分娩组比较，二者差异有统计学意义(0.05)。孕28～33+6周潜伏期≤24 h与潜伏期gt;24 h比较，新生儿窒息有差异有统计学意义(0.05)，孕34～36+6周潜伏期gt;24 h与潜伏期≤24 h比较，新生儿感染差异有统计学意义(0.05)。孕28～33+6周未足月胎膜早破新生儿窒息。围产儿死亡率明显高于孕34～36+6周,差异有统计学意义(0.05)。结论 对不同孕周的胎膜早破应采取不同的治疗方法。孕28～34周胎膜早破产妇，宜采取期待疗法，通过正确应用预防感染、促进胎肺成熟及抑制子宫收缩等方法，以达到提高新生儿存活率，减少新生儿并发症之目的。选择合适分娩时机及分娩方式，能获得良好妊娠结局。 【关键词】 未足月胎膜早破;期待治疗;妊娠结局 　　[Abstract] Objective To analyze clinical management and pregnancy outcome in pregnancy complicated with preterm premature rupture of membranes(PPROM).Methods The clinical data of 124 patients with premature rupture of membranes in Huadu Hospital Affiliated to South Medical University from January 2005 to December 2008 were retrospectively studied.Twenty six patients with preterm premature rupture of the membranes at 28～33+6 weeks were selected as group A,while 98 patients with premature rupture of membranes at 34～36+6 weeks as group B.At the same time randomly selected full-term pregnancy with unbroken membranes hospitalized in the same period,248 cases was as contrast group for comparison.Results In patients at 28～33+6 weeks gestation compared with 34～36+6 weeks gestation on PPROM，the puerperal infection,postpartum hemorrhage and delivery methods was no statistically differences(Pgt;0.05).The postpartum hemorrhage of PPROM group compared with the full-term delivery,the difference was statistically significant(0.05).The latent period≤24 hours compared with latent periodgt;24 hours on the patients at 28～33+6 weeks of PPROM，the asphyxiated newborns was statistically differences(0.05).The latent periodgt;24 hours compared with latent period≤24 hours on the patients at 34～36+6 weeks of PPROM，the neonatal infection was statistically differences(0.05).Th