早期新生儿肺炎与分娩方式相关性分析

The correlation between the early neonatal pulmonary infection and childbirth way

目的分析早期新生儿肺炎与其分娩方式的相关性。方法选取浙江省舟山医院妇幼保健院收治的11 532例新生儿为观察对象,比较不同分娩方式出生的早期新生儿肺炎发生情况和细菌培养结果。结果剖宫产组5768例患者中,肺部感染患儿48例,肺部感染率为0.83%,高于顺产组的0.45%,2组比较差异有统计学意义(P<0.05)。2组患儿细菌培养结果无明显差别,各菌种构成比比较差异无统计学意义(均P>0.05)。2组患儿主要致病菌均为金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌。金黄色葡萄球菌对头孢他啶、头孢西丁和环丙沙星耐药,耐药率分别为64.71%、52.94%和52.94%;肺炎克雷伯菌对环丙沙星和哌拉西林他唑巴坦耐药,耐药率均为57.14%;大肠埃希菌对环丙沙星耐药,耐药率为69.23%;金黄色葡萄球菌对万古霉素敏感。结论剖宫产影响新生儿免疫系统发育,使早期新生儿肺炎率增加,减少无医学手术指征的剖宫产,有助于降低早期新生儿肺炎的发生。

Objective To explore the correlation between the early neonatal pulmonary infection and childbirth way. Methods 11 532 cases of neonatal were selected as the observation objects. The early neonatal pulmonary infection oc- currence and the bacterial culture results between the different delivery way born were compared. Results 5768 cases of neonatal in the cesarean delivery group,48 cases had pulmonary infection, the pulmonary infection rate was 0.83% ,which was higher than that of eutocia group, the comparing difference was statistically significant（P 〈 0.05 ）. The bacterial cul- ture results between the two groups showed no obvious difference, the species composition comparison difference had no statistical significance （P 〉 0.05 ）. The main pathogenic bacteria of the two groups were staphylococcus aureus, klebsiella pneumoniae and e. coll. The staphylococcus aureus were resistant to cephalosporin, cefoxitin, and ciprofloxacin; the drug resistance rate were 64.71% ,52.94% and 52.94% respectively ;the klebsiella pneumoniae was resistant to ciprofloxacin and piperacillin-tazobactam,the drug resistance rate were 57.14% and 57.14% respectively;E, coli was resistance to ciprofloxacin,the drug resistance rate was 69.23% ;the staphylococcus aureus, klebsiella pneumoniae and E. coli were sensitive to vancomycin. Conclusion The cesarean delivery affected early neonatal immune system development, which made the early neonatal pulmonary infection rate increases, and to reduce the cesarean section without medical surgical in- dications helps to reduce early neonatal pulmonary infection occurred.