抗菌药物预防羊水Ⅲ度胎粪污染新生儿感染的必要性及安全性评价

Necessity and safety evaluation of antibiotics for prevention of neonatal infection caused by Ⅲ-degree of meconium staining of the amniotic fluid

目的探讨对羊水Ⅲ度胎粪污染的新生儿应用抗菌药物预防感染的必要性、安全性及合理方法。方法 86例仅存Ⅲ度粪染无合并其他感染因素的新生儿,采用随机数字表法分为对照组和观察组,每组43例。对照组患儿不给予抗菌药物,观察组患儿行抗菌药物预防感染3 d。患儿出生后3 d,确认其是否感染,确诊感染的患儿开始给予抗菌药物(对照组)或继续给予抗菌药物(实验组)抗感染治疗直至恢复正常。比较两组患儿的感染发生情况及宫内窘迫、窒息、肺炎、心动过缓、心血管适应障碍等不良反应发生情况。结果观察组患儿的感染发生率为4.65%,明显低于对照组的18.60%,差异有统计学意义(χ^2=4.0737, P=0.0436<0.05)。观察组患儿的宫内窘迫、窒息、肺炎、心动过缓、心血管适应障碍等不良反应发生率为9.30%,明显低于对照组的32.56%,差异有统计学意义(χ^2=7.0261,P=0.0080<0.05)。结论抗菌药物对存在羊水Ⅲ度胎粪污染高危因素的新生儿有一定预防感染的效用,且具有必要性、安全性,并能有效预防新生儿相关性疾病的发生,值得临床推广。

Objective To discuss the necessity, safety and reasonable methods of antimicrobial agents for prevention of neonatal infection caused by Ⅲ-degree of meconium staining of the amniotic fluid. Methods A total of 86 neonates with only Ⅲ-degree of meconium staining of the amniotic fluid and no other infectious factors were divided into control group and observation group by random number table method, with 43 cases in each group. The control group received no antibiotics, and the observation group received antibiotics to prevent infection for 3 d. At 3 d after birth, children with confirmed infection was treated with antibiotics (control group) or continued antibiotics (experimental group) antibiotics until they returned to normal. Comparison were made on occurrence of infection and adverse reactions of intrauterine distress, asphyxia, pneumonia, bradycardia and cardiovascular adaptation disorder were compared between the two groups. Results The observation group had obviously lower incidence of infection as 4.65% than 18.60% in the control group, and the difference was statistically significant (χ^2=4.0737, P=0.0436<0.05). The observation group had obviously lower incidence of adverse reactions of intrauterine distress, asphyxia, pneumonia, bradycardia and cardiovascular adaptation disorder as 9.30% than 32.56% in the control group, and the difference was statistically significant (χ^2=7.0261, P=0.0080<0.05). Conclusion Antibiotics have a certain preventive effect on newborns with high risk factors of Ⅲ-degree of meconium staining of the amniotic fluid, and it contains necessary and safety. It can effectively prevent the occurrence of neonatal-related diseases, and is worthy of clinical promotion.