胎膜早破伴新生儿感染的高危因素分析及其临床意义.PDF

2011;31(3) 南方医科大学学报（J South Med Univ ） ·465 · ·临床研究· 胎膜早破伴新生儿感染的高危因素分析及其临床意义 靳 瑾，张 燕，王志坚，钟 梅，余艳红 南方医科大学南方医院妇产科，广东广州510515 摘要：目的探讨胎膜早破伴新生儿感染的高危因素及意义。方法 将我院2005 年1月至2009 年12月收治的42 例胎膜早 破伴新生儿感染的患者为观察组进行回顾性分析，并随机抽取相同时期相同孕周胎膜早破孕妇但未出现新生儿感染者42 例为对照组，从分娩孕周、破膜距胎儿分娩时间、分娩方式、胎盘病理、孕妇血清C 反应蛋白浓度、白细胞及中性粒细胞值 等方面探讨胎膜早破与新生儿感染的关系。结果 胎膜早破组破膜距胎儿分娩时间较对照组有显著延长（P0.05）；胎膜 早破组患者“胎膜炎”的发生率较对照组显著升高（P0.05）；未足月胎膜早破者胎膜炎及新生儿败血症发生率较对照组显 著升高(P0.05)。结论 在动态监测生化指标变化、综合判定感染征象后适当延长孕周以及适时终止妊娠对于降低胎膜早 破伴新生儿感染率有重要意义。 关键词：胎膜早破；C反应蛋白；白细胞；新生儿感染 中图分类号：R473.72 文献标志码：A 文章编号：1673-4254（2011）03-0465-04 Risk factors of premature rupture of membranes with neonatal infection: a single-center study JIN Jin, ZHANG Yan, WANG Zhi-jian, ZHONG Mei, YU Yan-hong Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China Abstract: Objective To analyze the high-risk factors of premature rupture of membranes (PROM) with neonatal infection and explore their clinical significance. Methods Forty-two cases of PROM with neonatal infections were retrospectively analyzed for the risk factors with another 42 PROM cases matched for gestational age without neonatal infections as the control group. The relations of gestational age, time from membrane rupture to delivery, mode of delivery, placental pathology, maternal serum C-reactive protein concentration, leukocyte and neutrophil values to neonatal infections were analyzed. Results The time from membrane rupture to delivery was significantly longer and the incidence of chorioamnionitis significantly higher in the study group (P0.05). Meningitis and neonatal sepsis occurred at