持续性与单次抗菌治疗对HIV感染妊娠者分娩结局的影响比较

Effect comparison of persistent and single antibacterial therapy on the delivery outcome of pregnant women with HIV infection

目的分析持续性与单次抗菌治疗对人类免疫缺陷病毒(HIV)感染妊娠者分娩结局的影响。方法选取2016年9月至2019年3月南京市浦口区中医院接收的120例HIV感染产妇作为研究对象。将剖宫产术前接受单次抗菌治疗的产妇作为对照组(n=60),将剖宫产术前接受持续性抗菌(延至术后48h)治疗的产妇作为研究组(n=60)。比较两组产妇临床相关指标、免疫功能、不良妊娠结局及术后感染率。结果研究组产妇术中出血量、术后3d CD4^+、CD8^+、CD4^+/CD8^+与对照组产妇相比,差异无统计学意义(P>0.05);研究组产妇体温恢复正常时间、白细胞计数下降时间及术后住院时间均比对照组产妇低,差异具有统计学意义(P<0.05);研究组产妇胎儿窘迫、胎膜早破、流产、新生儿窒息等不良妊娠发生率与对照组产妇相比,差异无统计学意义(P>0.05);研究组产妇切口感染、产褥感染、泌尿感染、宫腔感染等总感染率比对照组产妇低,差异有统计学意义(P<0.05)。结论剖宫产术前持续性与单次抗菌治疗对HIV感染妊娠者的分娩结局、产妇免疫功能无明显影响,但延长抗菌治疗至术后48h利于加快体温恢复,降低术后并发症及感染风险。

Objective To analyze the effect of persistent and single antibacterial therapy on the delivery outcome of pregnant women with human immunodeficiency virus(HIV)infection.Methods The clinical data of 120 HIV infected parturients from Pukou District Hospital of traditional Chinese medicine from September 2016 to March 2019 were collected.60 pregnant women with single antibacterial therapy before cesarean section were selected as control group,and 60 pregnant women with persistent antibacterial therapy(extended to 48 h after operation)before cesarean section were selected as research group.Maternal clinical indicators,immune function,adverse pregnancy outcome and postoperative infection rates were compared between the two groups.Results There were no significant differences in the amount of intraoperative bleeding,levels of CD4^+,CD8^+and CD4^+/CD8^+at 3 days after operation between the two groups(P>0.05).The recovery time of body temperature,decline time of white blood cell count and postoperative hospital stays in research group was shorter than that in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of fetal distress,premature rupture of membrane,abortion,neonatal asphyxia between the two groups(P>0.05).The total rate of incision infection,puerperal infection,urinary infection and intrauterine infection in the research group were lower than those in the control group(P<0.05).Conclusions Persistent and single antibacterial therapy before cesarean section have no significant effect on the delivery outcome,maternal immune function of pregnant women with HIV infection.However,prolonging the antibacterial therapy to 48 h after operation is beneficial to accelerating the recovery of body temperature,and reducing the risk of postoperative complications and infection.