影响未足月胎膜早破患者发生HCA的因素

Factors Influencing the Occurrence of HCA in Patients with Preterm Premature Rupture of Membranes

目的:分析影响未足月胎膜早破(PPROM)孕妇发生绒毛膜羊膜炎(HCA)的因素。方法:回顾性分析2017年1月-2020年6月本院257例PPROM孕妇临床资料,根据胎盘病理检查结果将发生HCA的孕妇纳入HCA组(36例),未发生HCA的孕妇纳入对照组(221例)。比较两组年龄、孕周、孕次、产次、羊水检测结果、C反应蛋白(CRP)及血红蛋白(Hb)水平、分娩方式、胎儿宫内窘迫、新生儿窒息、新生儿重症监护等一般资料,选取差异有统计学意义的因素进行Logistic多元回归分析。结果:两组年龄、产次、羊水检测、CRP及Hb水平、分娩方式、新生儿重症监护治疗比较差异有统计学意义(P<0.05),两组孕次、孕周、胎儿宫内窘迫及新生儿窒息比较差异无统计学意义(P>0.05)。Logistic多元回归分析显示,高龄、多次分娩、羊水检测阳性、剖宫产及Hb水平偏低均为PPROM孕妇发生HCA的独立危险因素(P<0.05)。结论:高龄、多次分娩次数、剖宫产、羊水检测阳性及Hb水平偏低均可增加PPROM孕妇HCA发生率,进而增加胎儿宫内窘迫、新生儿重症等风险,临床上应对存在此类因素的孕妇引起重视,尽早采取相应措施,减少PPROM孕妇HCA发生。

Objective:To analyze the factors affecting histologic chorioamnionitis (HCA) in pregnant women with premature rupture of membranes (PPROM).Method:The clinical data of 257 cases of PPROM pregnant women from January 2017 to June 2020 in our hospital were retrospectively analyzed.Pregnant women with HCA were included in the HCA group (36 cases) and pregnant women without HCA were included in the control group (221 cases) according to the placenta pathological examination results.The age,gestational weeks,times of pregnancy,times of delivery,amniotic fluid test results,C-reactive protein (CRP) and hemoglobin (Hb) levels,mode of delivery,fetal distress,neonatal asphyxia,neonatal intensive care of general data were compared between the two groups.Logistic multiple regression analysis was performed on the factors with significant differences.Result:There were significant differences in age,times of delivery,amniotic fluid detection,CRP and Hb levels,mode of delivery,neonatal intensive care between the two groups (P<0.05),there were no significant differences in times of pregnancy,gestational weeks,fetal distress and neonatal asphyxia between the two groups (P>0.05).Logistic multiple regression analysis showed that the elderly,multiple delivery times,positive amniotic fluid detection,cesarean section and low Hb level were independent risk factors of the occurrence of HCA in PPROM pregnant women (P<0.05).Conclusion:Elderly,multiple delivery times,cesarean section,positive amniotic fluid detection and low Hb level can increase the incidence of HCA in PPROM pregnant women,and then increase the risk of fetal distress and neonatal severe disease.We should pay attention to the pregnant women with such factors,and take corresponding measures as soon as possible to reduce the incidence of HCA in PPROM pregnant women.