妊娠晚期胎膜早破孕妇宫颈分泌物培养与新生儿感染分析

The analysis of premature rupture of membranes in late pregnancy cervical secretions cultivation and neonatal infections

目的探讨妊娠晚期胎膜早破孕妇宫颈分泌物培养情况与新生儿感染的关系。方法选取2013年1月至2015年12月就诊于本院的1140例妊娠晚期胎膜早破的孕妇纳入胎膜早破组,选取本院同期1054例妊娠晚期无胎膜早破的孕妇纳入对照组,观察并分析两组孕妇宫颈分泌物的培养情况、早产、产褥感染、新生儿黄疸、新生儿感染、低体重儿和新生儿死亡等情况。结果胎膜早破组769例孕妇宫颈分泌物培养提示带菌,对照组660例孕妇宫颈分泌物培养提示带菌,且两组孕妇菌群分布均以白色假丝酵母菌最为多见,胎膜早破组孕妇宫颈分泌物中乳杆菌、不动杆菌所占比例分别为16.78%和1.43%,对照组分别为13.79%和0.30%,两组比较差异显著(P<0.05)。胎膜早破组新生儿分泌物中大肠埃希菌所占比例为35.92%,对照组为23.75%,两组比较差异显著(P<0.05)。胎膜早破组产褥感染、新生儿黄疸、新生儿感染、新生儿死亡、低体重儿的发生率均高于对照组(P<0.05)。结论妊娠晚期孕妇阴道菌群以假丝酵母菌居多,阴道菌群失衡导致胎膜早破、产褥感染、新生儿感染等的发生率增加。

Objective To investigate the relationship between the cultivation of cervical secretion in the late pregnancy with premature rupture of membranes and neonatal infection. Method From January 2013 to December 2015, 1140 cases of gravida with premature rupture of membranes in our hospital were adopted in premature rupture of membranes group, and 1054 cases of pregnant women were adopted in control group. Observed and analyzed the cultivation of cervical secretions, premature delivery, puerperal infection, neonatal jaundice, neonatal infection, low birth weight infant and neonatal death. Result Cultivation of cervical secretion of 769 gravida showing a bacterial phenomenon in premature rupture of membranes group, 660 cases in control group, and the Candida albicans was the most common in the two groups. Distribution of Lactobacillus and Acinetobacter in premature rupture of membranes group（16.78%, 1.43%） were higher than control group（13.79%, 0.30%）（P〈0.05）. The distribution of Escherichia coli in premature rupture of membranes group（35.92%） was significantly higher than control group（23.75%）（P〈0.05）. The incidence rate of puerperal infection, neonatal jaundice, neonatal infection, low birth weight infant and neonatal death in premature rupture of membranes group were higher than control group（P〈0.05）. Conclusion Candidiasis is the most vaginal flora of late trimester of pregnancy gravida, the vaginal flora imbalance leads the increase of incidence rate of premature rupture of membranes, puerperal infection and neonatal infection.