妊娠合并急性肾盂肾炎48例分析

Analysing 48 Cases of Acute Pyelonephritis in Pregnancy

目的 探讨妊娠期急性肾盂肾炎(GAPN) 对妊娠的影响及其治疗措施。方法 对48 例GAPN 进行回顾性分析。结果 GAPN 的主要致病菌为大肠杆菌(65 % ) ,且82 % 的杆菌对氨苄青霉素耐药。抗菌疗程4 周者再发率(10 % ) 明显低于3 周者(32 % ) ,差异显著( P < 0-01) 。48 例中流产1 例,早产3 例。结论 GAPN 多在妊娠中、晚期发病,重者可致流产、早产。治疗首选头孢菌素,疗程以4 周为好。应重视孕早期尿菌普查,积极治疗真性菌尿有望减少GAPN 的发生。

Objective\ To investigate the effects of acute pyelonephritis(APN)on pregnancy and assess the treatment of gravidic acute pyelonephritis(GAPN).Methods\ 48 cases of GAPN were analysed retrospectively.Results\ Main pathogen of GAPN was coli bacillus(65%),and 82% of the bacillus was resistent to ampicillin.The recurrent rate of GAPN with 4 weeks of medical treatment was significantly lower than that with 3 weeks(P<0 01).Among these cases,1 was abortion and 3 premature birth.Conclusions\ Most GAPN happened during the middle and late stages of pregnancy,the serious cases of which could lead to premature birth or abortion The first choice of medication should be cephalosporins and the period of the treatment should better be 4 weeks.It is suggested that bacteriuria should be generally surveyed in the earlier stage of prenancy.The incidece of GAPN may be reduced by the effective treatment of real bacteriuria.