未足月胎膜早破治疗中抗生素应用时间对母婴结局的作用分析

Effect of Antibiotic Application Time on Maternal and Infant Outcomes in the Treatment of Preterm Premature Rupture of Membranes

目的 分析抗生素应用时间不同对未足月胎膜早破(premature rupture of membranes, PROM)的治疗效果。方法 方便选择2018年6月—2022年5月南京市江宁医院产科接收的62例未足月PROM产妇为研究对象,依据抗生素使用时间将产妇分为两组,胎膜早破12~24 h予以抗生素治疗的30例纳入对照组,胎膜早破<12 h予以抗生素治疗的32例纳入观察组。对比两组产妇孕周延长时间、产后出血量、新生儿阿氏评分(Apgar)、炎症指标、产妇妊娠结局及新生儿结局。结果 治疗后,观察组孕周延长时间长于对照组,产后2、24 h出血量少于对照组,新生儿1、5 min Apgar评分高于对照组,差异有统计学意义(P<0.05);治疗后,观察组炎症指标(PCT水平)低于对照组,差异有统计学意义(P<0.05);观察组难产、产褥感染、绒毛膜羊膜炎、产后出血、宫内感染的总发生率为9.38%,低于对照组的30.00%,差异有统计学意义(χ^(2)=4.220,P<0.05);观察组新生儿宫内窘迫、产后7 d内新生儿感染、新生儿窒息、低出生体质量的总发生率为9.38%,低于对照组的33.33%,差异有统计学意义(χ^(2)=5.363,P<0.05)。结论 未足月PROM治疗中12 h内实施抗生素治疗效果更为理想,可降低炎症指标,改善母婴结局。

Objective To analyze the therapeutic effect of antibiotic application time on preterm premature rupture of membranes(PROM).Methods 62 cases of non-term premature ruprure of membranes(PROM)received by obstetrics Department of Nanjing Jiangning Hospital from June 2018 to May 2022 were conveniently selected as the study ob⁃jects.According to the time of antibiotic use,the parturients were divided into two groups.Thirty cases of premature rupture of membranes were treated with antibiotics 12-24 h into the control group,and thirty-two cases of premature rupture of membranes<12 h were treated with antibiotics into the observation group.The prolonged gestation time,postpartum blood loss,Apgar score,inflammation index,maternal pregnancy outcome and neonatal outcome were com⁃pared between the two groups.Results After treatment,the prolongation time of gestational week in observation group was longer than that in control group,the postpartum blood loss at 2 h and 24 h was less than that in control group,the 1 min and 5 min Apgar scores of neonates were higher than those of control group,the difference was statistically sig⁃nificant(P<0.05).After treatment the inflammation index(PCT level)in observation group was lower than that in con⁃trol group,the difference was statistically significant(P<0.05).The total incidence of dystocia,puerperal infection,chorioamnitis,postpartum hemorrhage and intrauterine infection in the observation group was 9.38%,which was lower than that in the control group(30.00%),the difference was statistically significant(χ^(2)=4.220,P<0.05).The total incidence of intrauterine distress,neonatal infection within 7 days after delivery,neonatal asphyxia and low birth weight in the observation group was 9.38%,which was lower than that in the control group(33.33%),the difference was statis⁃tically significant(χ^(2)=5.363,P<0.05).Conclusion In the treatment preterm PROM,the effect of antibiotic therapy within 12 h is more ideal,which can reduce inflammation indicators and improve maternal and infant outcomes.