青霉素对妊娠晚期GBS感染孕妇母婴结局的影响

Effect of penicillin on maternal and infant outcomes of pregnant women with GBS infection in third trimester of pregnancy

目的研究青霉素对妊娠晚期B族链球菌(GBS)感染孕妇对母婴结局的影响。方法将2017年1月至2019年12月我院收治的80例妊娠晚期GBS感染孕妇根据抽签法随机分为对照组与观察组,各40例。对照组采取基础助产以及引产等对症分娩干预措施,观察组在对照组基础上给予青霉素治疗。比较两组治疗前、后的白细胞介素6(IL-6)、白细胞计数(WBC)、降钙素原(PCT)水平和凝血功能指标,并记录两组孕妇和新生儿不良结局发生情况。结果治疗后,观察组的IL-6、WBC和PCT水平均低于治疗前和对照组(P<0.05)。治疗后,观察组的凝血酶原时间、国际标准化比率、活化部分凝血活酶时间均优于治疗前和对照组,纤维蛋白原水平低于治疗前和对照组(P<0.05)。观察组的剖宫产、早产、胎膜早破、霉菌性阴道炎及产褥感染发生率均低于对照组(P<0.05)。观察组的胎儿窘迫、宫内感染、新生儿肺炎、新生儿窒息及胎儿生长受限发生率均低于对照组(P<0.05)。结论青霉素治疗妊娠晚期GBS感染孕妇可明显改善凝血功能,有效改善母婴结局,值得临床推广。

Objective To study the effect of penicillin on maternal and infant outcomes of pregnant women with group B Streptococcus(GBS)infection in third trimester of pregnancy.Methods A total of 80 pregnant women with GBS infection in third trimester of pregnancy admitted in our hospital from January 2017 to December 2019 were randomly divided into control group and observation group by the method of drawing lots,with 40 cases in each group.The control group was given intervention measures for symptomatic delivery such as basic midwifery and induction of labor,and the observation group was treated with penicillin on the basis of the control group.The levels of interleukin-6(IL-6),white blood cell count(WBC),procalcitonin(PCT)and coagulation function indexes were compared between the two groups before and after treatment,and the adverse outcomes of pregnant women and newborns in the two groups were recorded.Results After treatment,the levels of IL-6,WBC and PCT in the observation group were lower than those before treatment and in the control group(P<0.05).After treatment,prothrombin time,international standardized ratio and activated partial thromboplastin time in the observation group were better than those before treatment and in the control group,and fibrinogen level was lower than that before treatment and in the control group(P<0.05).The incidence of cesarean section,premature delivery,premature rupture of membranes,mycotic vaginitis and puerperal infection in the observation group were lower than those in the control group(P<0.05).The incidence of fetal distress,intrauterine infection,neonatal pneumonia,neonatal asphyxia and fetal growth restriction in the observation group were lower than those in the control group(P<0.05).Conclusion Penicillin in the treatment of pregnant women with GBS infection in third trimester of pregnancy can significantly improve the coagulation function,effectively improve the maternal and infant outcomes,which is worthy of clinical promotion.