组织学绒毛膜羊膜炎对剖宫产术后感染的影响及原因分析

The effect of histological chorioamnionitis on infection after cesarean section and cause analysis

目的本文主要探讨组织学绒毛膜羊膜炎对剖宫产术后切口感染和子宫内膜炎发生率的影响及原因。方法回顾性分析2017年1月1日至2019年9月1日在我院行剖宫产手术分娩产妇的临床资料,依据产后胎盘病检结果将其分为未发生绒毛膜羊膜炎的对照组374例和发生组织学绒毛膜羊膜炎的观察组228例,再依据病史是否发生胎膜早破膜,将观察组细分为观察组胎膜早破亚组137例和观察组未胎膜早破亚组91例,对照组细分为对照组胎膜早破亚组233例和对照组未胎膜早破亚组141例。比较观察组和对照组组间及各相应亚组间的切口感染和子宫内膜炎发生率。结果观察组患者剖宫产术后切口感染和子宫内膜炎发生率均明显高于对照组(P<0.05);观察组中胎膜早破亚组患者术后切口感染和子宫内膜炎发生率明显高于对照组中胎膜早破亚组(P<0.05),两组中未胎膜早破亚组术后切口感染和子宫内膜炎发生率差异无统计学意义(P>0.05)。结论发生组织学绒毛膜羊膜炎可增加患者剖宫产术后切口感染和子宫内膜炎发生率,且胎膜早破很大可能是造成升高的重要原因。

Objective To investigate the effect of histological chorioamnionitis(HCA)on infection after cesarean section.Methods Clinical data of patients who underwent cesarean section in our hospital from Jan.1.2017 to September.1.2019 were retrospectively analyzed.According to results of placenta pathological examination,the patients were divided into control group(n=374)without HCA and observation group(n=228)with HCA.According to premature rupture of membranes,the observation group was further divided into premature rupture of membranes group(n=137)and no premature rupture of membranes group(n=91).The control group was also further divided into premature rupture of membranes group(n=233)and no rupture of membranes group(n=141).The rate of endometritis and surgical site infection after cesarean section were compared among the four groups.Results The incidence of endometritis and surgical site infection after cesarean section in the observation group was higher than that in the control group(P<0.05).The incidence of endometritis and surgical site infection after cesarean section in the patients with the premature rupture of membranes in the observation group was higher than that in patients with premature rupture of membranes in the control group(P<0.05),but no significant difference between the patients without the premature rupture of membranes in the observation group and the patients without the premature rupture of membranes in the control group(P>0.05).Conclusion The incidence of endometritis and surgical site infection after cesarean section in the patients with HCA are associated with the premature rupture of membranes.