孕晚期生殖道B族链球菌感染的临床干预及新生儿结局分析

Clinical Intervention of Genital Tract Group B Streptococcal Infection in the Later Pregnancy and Analysis of Neonatal Outcome

目的:探讨与分析孕晚期生殖道B族链球菌(GBS)感染的临床干预及新生儿结局。方法:选取2017年6-12月在本院产检并自愿检测GBS抗原的孕35~37周孕妇500例,运用免疫层析法快速检测生殖道GBS抗原,筛查出GBS阳性组150例,GBS阴性组350例,将GBS阳性组随机分为治疗组(75例)和对照组(75例)。治疗组采取针对性临床干预,而其余两组均未实施干预。观察记录三组新生儿B族链球菌感染率及新生儿肺炎、新生儿败血症、新生儿脑膜炎的不良结局。结果:GBS阳性对照组新生儿B族链球菌感染率及新生儿肺炎、新生儿败血症、新生儿脑膜炎不良结局发生率均明显高于GBS阳性治疗组及GBS阴性组,差异均有统计学意义(P<0.05);而GBS阴性组与GBS阳性治疗组对比,差异均无统计学意义(P>0.05)。结论:孕晚期生殖道B族链球菌感染可增加不良新生儿结局发生率,而采取免疫层析法快速诊断孕妇生殖道GBS感染并行临床干预后可改善新生儿不良结局,可望在产科临床推广应用。

Objective：To investigate and analyze the clinical intervention and neonatal outcome of genital tract group B streptococcal（GBS） infection in the later pregnancy.Method：500 pregnant women of 35-37 weeks of gestation from June 2017 to December 2017 of our hospital were selected for pregnancy test.GBS antigen of genital tract was detected by immunochromatography.150 cases of GBS positive group and GBS negative group of 350 cases,the GBS positive group were randomly divided into treatment group（75 cases） and control group（75 cases）.The treatment group was taken targeted clinical intervention,while the other two groups did not implement intervention.The infection rate of neonatal group B streptococcus and the adverse outcomes of neonatal pneumonia,neonatal septicemia and neonatal meningitis were observed and recorded.Result：The positive rate of group B streptococcal infection in neonates with GBS positive control group was significantly higher than those in GBS positive treatment group and GBS negative group,as well as neonatal pneumonia,neonatal sepsis and neonatal meningitis,the differences were statistically significant（P〈0.05）;there were no significant differences between GBS negative group and GBS positive treatment group（P〉0.05）.Conclusion：In the later pregnancy,genital tract group B streptococcal infection can increase the incidence of adverse neonatal outcomes,however,immunochromatography can be used to diagnose the genital tract GBS infection in pregnant women rapidly and improve the neonatal adverse outcomes after clinical intervention,it is expected that in clinical obstetrics application.