抗生素应用时机对未足月胎膜早破孕妇母婴结局的影响

Influence of antibiotic application time on maternal and neonatal outcomes of pregnant women with preterm premature rupture of membrane

目的研究胎膜早破孕妇中抗生素给药时间及其对母婴的影响。方法选取2016年1月至2016年7月四川大学华西广安医院住院治疗的胎膜早破<24小时内使用抗生素的孕妇为研究组(102例),选取同期该院住院治疗的胎膜早破24~48小时内使用抗生素的孕妇为对照组(102例),两组孕妇均采用相同抗生素治疗方案预防感染。比较两组产妇绒毛膜羊膜炎、产后出血、产褥感染、新生儿感染的发生情况及新生儿Apgar评分情况。结果研究组产妇的绒毛膜羊膜炎、产后出血、产褥感染的发生率分别为7.84%、1.96%、1.96%,均显著低于对照组的17.65%、9.80%、8.82%(χ~2值分别为4.408、5.667和4.708,均P<0.05)。研究组新生儿Apgar≥8分、Apgar 4~7分和Apgar≤3分分别为92.16%、7.84%和0;对照组新生儿Apgar≥8分、Apgar4~7分和Apgar≤3分别为75.49%、18.63%和5.88%,研究组新生儿Apgar评分显著优于对照组(Fisher检验,P=0.02)。研究组新生儿感染率为0.98%,显著低于对照组的7.84%(χ~2=4.185,P<0.05)。结论胎膜早破24小时内预防性使用抗生素可减少绒毛膜羊膜炎、产后出血、产褥感染、新生儿感染的的发生。

Objective To study the antibiotic application time and its influence on maternal and neonatal outcomes in pregnant women with preterm premature rupture of membranes.Methods Pregnant women with preterm premature rupture of membrane hospitalized and treated in West China Guang＇an Hospital of Sichuan University from January to July 2016 were selected,and among them patients receiving antibiotic treatment within 24 hours were selected as study group（102 cases）,and patients receiving antibiotic treatment in 24-48 hours were assigned into control group（102 cases）.Same antibiotic therapy was used in two groups to prevent infection.Chorioamnionitis,postpartum hemorrhage,puerperal infection neonatal infection and neonatal Apgar score were compared in two groups.Results Incidence rates of chorioamnionitis,postpartum hemorrhage and puerperal infection in study group were 7.84%,1.96% and 1.96%,respectively,which were significantly lower than those in control group（17.65%,9.80%,8.82%）（χ^2 value was 4.408,5.667 and 4.708 respectively,all P〈0.05）.Proportions of infants with Apgar score≥8,in 4-7 and ≤3 in study group were 92.16%,7.84% and 0,respectively,while those in control group were 75.49%,18.63% and 5.88%,respectively.Apgar scores of infants in study group were significantly better than those in control group（P〈0.05）.Neonatal infection rate in study group was 0.98%,which was significantly lower than that of 7.84%in control group（χ^2=4.185,P〈0.05）.Conclusion Prophylactic antibiotic treatment within 24 hours for preterm premature rupture of membrane can obviously reduce incidences of chorioamnionitis,postpartum hemorrhage,puerperal infection and neonatal infection.