早产合并胎膜早破102例临床分析

Clinical Analysis of 102 Cases with Preterm Premature Rupture of Membranes

目的探讨早产合并胎膜早破(简称PPROM)的发病因素、分娩方式、治疗方法及妊娠结局。方法整群选取2013年1月—2014年10月在该院住院治疗的早产合并胎膜早破的102例患者作为研究对象,在相同时期内该院分娩总数为6256例,早产合并胎膜早破的患者占分娩总数的1.9%,早产311例,PPROM占早产总数32.8%,对其进行回顾性分析。结果早产合并胎膜早破发病因素主要是阴道炎(27.5%)、胎位异常(14.7%)、双胎妊娠(11.8%)、原因不明(25.4%)等;不同孕周的早产合并胎膜早破新生儿结局差异不同,其中<34周的围生儿死亡率最高,为25%,与其他孕周相比较,差异具有统计学意义(P<0.05)。结论对孕周<34周早产合并胎膜早破、无明显感染迹象者,应期待治疗、延长孕周、减少围生儿合并症发生、降低围生儿死亡率;孕周>34周,胎肺基本达到成熟,可以进行自然生产,随时停止妊娠,需要时可以进行引产来终止妊娠。

Objective To investigate the risk factors, delivery methods, treatment methods and outcomes of preterm prema-ture rupture of membranes （PPROM）. Methods 102 cases with PPROM underwent hospitalization in our hospital from Jan-uary 2013 to October 2014 were selected as the subjects, which accounted for 1.9%of the 6256 cases delivered in our hos-pital during the same period. 311 cases had premature delivery, of which, PPROM cases accounted for 32.8%. A retrospec-tive analysis was conducted on it. Results The pathogenic factors of PPROM were mainly vaginitis （27.5%）, abnormal fetal position （14.7%）, twin pregnancy（11.8%）, and unexplained reasons（25.4%）. PPROM patients with different gestational weeks had different neonatal outcomes. Those with gestational weeks less than 34 had the highest perinatal mortality （25%）, com-pared with the perinatal mortality occurred in those with other gestational weeks, the difference was statistically significant （P〈0.05）. Conclusion The PPROM pregnant women with the gestational weeks less than 34 and no obvious infection, should expect to be treated so as to prolong the gestational age and reduce the incidence of perinatal complications and perinatal mortality;for those with gestational weeks longer than 34 weeks, the fetal lungs are matured basically, they can undergo the natural labor and terminate the pregnancy at any time, and when necessary, the pregnancy can be terminated by induced labour.