妊娠期尿路感染的危险因素分析及预防对策

Risk factors of urinary tract infections during pregnancy and prevention countermeasures

目的探讨妊娠期尿路感染的相关危险因素并提出相应的预防对策,降低感染发生率。方法选取妊娠期尿路感染患者108例及同期无尿路感染的孕妇103例,对两组孕妇临床资料进行统计,测定两组患者体重指数、血红蛋白及血清白蛋白水平。结果≥35岁、文化程度较低、以往有尿路感染史、分娩史、流产史、贫血、合并妊娠期糖尿病均为妊娠期尿路感染的高危因素;经过logistic回归分析,年龄≥35岁、文化程度在高中及以下、既往有尿路感染史、分娩史、流产史以及贫血、合并妊娠期糖尿病是妊娠期尿路感染的独立危险因素(P<0.05);108例尿路感染患者在清洁中段尿中分离出89株病原菌,以大肠埃希菌最多,占67.42%,其他依次为肺炎克雷伯菌、粪肠球菌,变形菌属、屎肠球菌、肺炎链球菌,分别占6.74%、6.74%、4.49%、3.37%、2.25%。结论妊娠期尿路感染的因素是相对复杂的,发生尿路感染的孕妇在使用药物时需要顾及到胎儿的安全,应给予孕妇必要的健康教育。

OBJECTIVE To study explore the related risk factors of urinary tract infections during the pregnancy and put forward corresponding prevention countermeasures so as to reduce the infection rate.METHODS A total of 108 cases of patients with urinary tract infections during the pregnancy and 103 pregnant women without urinary tract infections were enrolled in the study,then the clinical data of the two groups were statistically analyzed,and the body mass index,hemoglobin level,and serum albumin level were determined.RESULTS The more than 35 years of age,low education level,history of urinary tract infections,delivery history,history of abortion,anemia,and complication of gestational diabetes were the high risk factors of the urinary tract infections during the pregnancy;The logisticregression analysis indicated that more than 35 years of age,education level of senior high school or below,history of urinary tract infections,delivery history,history of abortion,anemia,and complication of gestational diabetes were the independent risk factors of the urinary tract infections during pregnancy（P 0.05）.A total of 89 strains of pathogens were isolated from the midstream urine of the 108 patients with urinary tract infections,among which the Escherichia coli was the most common species,accounting for 67.42%,followed by Klebsiella pneumoniae（6.74%）,Enterococcus faecalis（6.74%）,Proteus（4.49%）,Enterococcus feces（3.37%）,and Streptococcus pneumoniae（2.25%）。CONCLUSION The factors associated with the urinary tract infections during pregnancy are complicated and are affected by multiple factors.The pregnant women with the urinary tract infections should take the safety of the fetus into consideration when using antibiotics,the medical staff should develop the necessary health education for the pregnant women.