妊娠期伤寒沙门菌感染的相关因素分析

Related factors for Salmonella typhi infection during pregnancy

目的：探讨妊娠合并伤寒沙门菌感染的相关因素，分析相应的护理对策，以降低妊娠期伤寒沙门菌的感染率。方法选取2010年1月-2013年9月21例妊娠合并伤寒沙门菌感染孕妇作为A组，22例伤寒沙门菌感染女性为B组，同时选择同期30例正常妊娠孕妇作为对照组，对感染的相关因素进行分析，同时分别检测血沉、血常规、肝功能及电解质的变化。结果 A、B组居住地为农村、营养状况差、免疫力低下、有合并症的构成比例明显高于对照组，差异有统计学意义（P＜0．05）；A组孕妇生化指标中白蛋白、前白蛋白、总白蛋白降低发生率明显高于B组与对照组，肝功能各指标升高发生率明显高于B组与对照组，白细胞下降、嗜酸性粒细胞下降发生率高于B组与对照组，电解质下降，血沉升高发生率高于B组与对照组，组间比较差异有统计学意义（P＜0．05）；经对症治疗后，A组所有孕妇在2～5d退热，平均退热时间（3．4＆#177;1．6）d，血常规、电解质在2周内恢复平常，肝功能指标在4周内恢复正常，除2例早期妊娠患者自愿终止妊娠外，其余19例孕妇均足月分娩，无1例出现新生儿窒息及胎儿异常。结论妊娠女性营养状况差、免疫力低下、卫生状况差，容易感染伤寒沙门菌，且感染后症状较未妊娠者严重，常伴有肝功能损害，在治疗与护理时应采取针对性地护理措施，最大限度地降低损害，保证母婴安全。

OBJECTIVE To explore the related factors for Salmonella typhi infection during the pregnancy and put forward corresponding nursing countermeasures so as to reduce the incidence of S .typhi infection during the preg-nancy .METHODS A total of 21 pregnant women complicated with S .typhi infection ,who were treated in the hos-pital from Jan 2010 to Sep 2013 ,were assigned as the group A ,22 female patients with S .typhi infection were set as the group B ,meanwhile ,30 pregnant women with normal pregnancy were assigned as the control group ;the related factors for the infection were analyzed ;the erythrocyte sedimentation rate ,blood routines ,liver function , and electrolytes indicators were respectively determined .RESULTS The constituent ratios of the participants who lived in rural area ,with poor nutrition status ,low immunity ,and complications were significantly higher in the group A and group B than in the control group（P＆lt;0 .05） .The incidence of reduction in the biochemical indicators such as the albumin ,prealbumin ,and total albumin was significantly higher in the group A than in the group B and the control group;the incidence of the elevated liver function indicators was significantly higher in the group A than in the group B and the control group ;the incidence of decrease in the white blood cell counts and eosinophils counts was higher in the group A than in the group B and the control group ;the incidence of decrease of electro-lytes or the increase of erythrocyte sedimentation rate was higher in the group A than in the group B and the con-trol group ,and there were significant between-group differences （P＆lt;0 .05） .All the pregnant in the group A re-lived from fever within 2-5 days ,with average time of fever （3 .4 ＆#177; 1 .6）days;the blood routines and electrolytes returned to normal within two weeks ;the liver function indicators recovered within 4 weeks .Totally 19 pregnant women delivered after full term of pregnancy ,2 pregnant women volunteered to terminate the pregnancy ,and there was no case of neonatal asphyxia or fetal abnormalities .CONCLUSION The pregnant women with poor nutri-tion status ,low immunity ,or poor health status tend to be infected with S .typhi ,with the symptoms more severe than those without pregnancy ;the pregnant women with S .typhi infection are usually complicated with liver func-tion damage .It is necessary to take targeted nursing measures so as to minimize the damage and ensure the safety of the mother and infant .