胎膜早破与生殖道感染的相关性探讨

Study on the association between genital infection and premature rupture of membranes

目的：探讨胎膜早破与感染的相关性。方法：回顾性分析2014年6月～2015年5月本院妇产科住院分娩的胎膜早破孕妇200例资料（观察组）,选取同期妇产科住院分娩的非胎膜早破孕妇200例作为对照组,分别对两组的入院血常规（包括血白细胞计数）、C-反应蛋白、阴道分泌物做白带常规（含阴道清洁度测定）、细菌培养、细菌性阴道病（BV）检测、宫颈分泌物检测沙眼衣原体（UU）及解脲支原体（CT）资料进行分析。结果：观察组CRP及白细胞值均高于对照组（t=17.80、12.45,均P〈0.01）;胎膜早破感染者CRP显著高于胎膜早破非感染者（t=35.73,P〈0.01）。观察组UU、CT、BV、白色念珠菌、滴虫及混合感染的发生率均高于对照组（χ^2=11.706,12.732,5.530,13.636,8.163,13.636,均P〈0.05）,生殖道感染率观察组（70%）高于对照组（30%）（χ^2=64.000,P〈0.05）。观察组新生儿早产、新生儿肺炎、新生儿窒息及孕妇产褥感染及产后出血的发生率均高于对照组（χ^2=29.249,24.242,35.470,9.338,9.421,均P〈0.05）。结论：胎膜早破与生殖道感染存在相关性,CT、UU、白色念珠菌为主要的病原体。因此妇女在计划妊娠前,首先要到医院进行生殖道病原学检查,及时发现感染并于孕前彻底治疗以降低胎膜早破及早产发生率,减少羊膜腔感染,降低母婴病率,提高围产保健质量。

Objective：To explore the association between genital infection and premature rupture of membranes.Methods：From June 2014 to May 2015,200 pregnant women with premature rupture of membranes were retrospectively analyzed as the observation group,while at the same time,200 pregnant women with non- premature rupture of membranes were retrospectively analyzed as the control group.Both in the two groups,routine blood tests（including blood leukocyte count）,C- reactive protein（CRP）,leucorrhea normal vaginal secretions（including the determination of vaginal cleanness）,bacteria culture,bacterial vaginal disease detection,cervical secretions for chlamydia trachomatis and urealyticum were analyzed.Results：CRP and blood leukocyte count of the observation group were significantly higher than those of the control group（t = 17.80,12.45,P〈0.01）.CRP of infected patients with premature rupture of membranes was significantly higher than that of non-infected patients（t = 35.73,P〈0.01）.In the observation group,the infection by UU,CT,BV,Candida albicans or trichomoniasis,and mixed infection were significantly higher than those in the control group,which difference had statistically significant（χ^2 = 11.706,12.732,5.530,13.636,8.163,13.636,respectively.P〈0.05）;The infection rates of the observation group（70%） was higher than that of and the control group（30%）,which had statistically significant difference（χ^2 = 64.000,P 0.05）.The incidence of Premature birth,puerperal infection,neonattal pneumoonia,puerperal puerperal morbidity morbidity,postpartum hemorrhage of the observation group are higher than that of control group（χ^2 = 29.249,24.242,35.470,9.338,9.421,respectively.P〈0.05）.Conclusions：There is a close correlation between the premature rupture of membranes and reproductive tract infections.In improving the quality of prenatal health care,in order to reduce the incidence of premature rupture of membranes and decrease the rate of maternal and infant disease,patients should accept genital tract etiology examination before planning pregnancy.