剖宫产影响下脓毒血症与子痫前期妊娠血常规参数对比分析

Comparative analysis of blood routine parameters between Pregnancy with sepsis and preeclampsia pregnancy After cesarean section

目的比较妊娠合并脓毒血症与子痫前期妊娠,剖宫产对血常规白细胞计数、中性粒细胞百分比、淋巴细胞百分比的变化影响,早期辨别危重症孕产妇,改善不良结局。方法回顾性分析从2020年于南方医科大学附属东莞市妇幼保健院危重症孕产妇救治中心重症医学科治疗的危重症孕产妇中筛选符合入选条件病例,子痫前期组患者46例,脓毒血症患者14例,从普通产科瘢痕妊娠中随机抽取并符合入选条件患者65例,比较分析三组妊娠孕产妇产剖宫产前后血常规白细胞计数、中性粒细胞百分比、淋巴细胞百分比变化。结果子痫前期组与脓毒血症组剖宫产前淋巴细胞百分比对比,差异具有统计学意义(P<0.05);术后第1天中性粒细胞百分比与淋巴细胞百分比对比,差异具有统计学意义(P<0.05)。子痫前期组与瘢痕子宫组剖宫产前白细胞计数对比,差异具有统计学意义(P<0.05);术后第1天术后白细胞计数、中性粒细胞百分比、淋巴细胞百分比比较,差异无统计学意义(P>0.05)。瘢痕子宫组与脓毒血症组剖宫产前白细胞计数、中性粒细胞百分比、淋巴细胞百分比对比,差异无统计学意义(P>0.05);术后第1天中性粒细胞百分比比较差异具有统计学意义(P<0.05)。结论剖宫产术后,单纯以白细胞计数,不能反映妊娠危重症程度,但中性粒细胞百分比,有助于将妊娠合并脓毒血症从正常因素剖宫产和子痫前期产妇中区别开,可用于早期辨别妊娠合并脓毒血症,改善不良结局。

Objectives Comparing pregnancy with sepsis and preeclampsia pregnancy,the influence of cesarean section on the changes of blood white blood cell count,neutrophil percentage,lymphocyte percentage,early identification of critically ill pregnant women,and improvement of adverse outcomes.Methods A retrospective analysis of the critically ill pregnant and lying-in women treated in the Critical Care Maternal Care Center of Dongguan Maternal and Child Health Hospital of Southern Medical University in 2020 that meets the criteria for selection,46 patients in the preeclampsia group,pregnancy with sepsis of the 14 patients,65 patients were randomly selected from general obstetric scar pregnancies and met the selection criteria.The blood routines of the three groups of pregnant women before and after cesarean section were compared and analyzed.Changes in white blood cell count,neutrophil percentage,and lymphocyte percentage.Results The percentage of lymphocyte before cesarean section between preeclampsia group and sepsis group was statistically significant(P<0.05).The percentage of neutrophil was significantly different from that of lymphocyte on day 1 after operation(PV0.05).The difference of white blood cell count before cesarean section between the preeclampsia group and the scar uterus group was statistically significant(P<0.05).There was no significant difference in postoperative white blood cell count,neutrophil percentage and lymphocyte percentage on the first day after surgery(P>0.05).There were no significant differences in white blood cell count,neutrophil percentage and lymphocyte percentage between the scar uterus group and the sepsis group before cesarean section(P>0.05).The percentage of neutrophil on day 1 after surgery was statistically significant(P<0.05).Conclusion After cesarean section,white blood cell count alone cannot reflect the degree of critical illness of pregnancy,but the percentage of neutrophils can help distinguish pregnancy complicated with sepsis from normal factors of cesarean section and preeclampsia.It can be used for Early identification of pregnancy complicated with sepsis,to improve adverse outcomes.