预防性抗生素治疗对胎膜早破患者宫内感染及母婴结局的影响

Effect of Prophylactic Antibiotic Therapy on Intrauterine Infection and Maternal and Infant Outcomes in Patients with Premature Rupture of Membranes

目的研究预防性抗生素治疗对胎膜早破患者宫内感染及母婴结局的影响。方法选取2020年1月-2022年12月龙南市第一人民医院接收的60例胎膜早破孕妇,依据随机数字表法分为对照组(30例)与观察组(30例)。观察组给予预防性抗生素治疗,对照组则不予抗生素治疗,比较两组分娩孕周、产后出血量、产后住院时间、围产结局(阴道分娩、剖宫产、早产)、产妇结局(绒毛膜羊膜炎、宫内感染、产褥感染、产后出血)、新生儿出生情况(新生儿体质量、新生儿Apgar评分)、新生儿结局(新生儿呼吸窘迫、新生儿肺炎、新生儿脑膜炎、新生儿败血症、死亡)。结果观察组分娩孕周晚于对照组,产后出血量少于对照组,且产后住院时间短于对照组(P<0.05)。观察组阴道分娩率高于对照组,剖宫产率、早产率小于对照组(P<0.05)。观察组产妇不良结局发生率小于对照组(P<0.05)。观察组新生儿体质量、新生儿Apgar评分大于对照组(P<0.05)。观察组新生儿不良结局发生率小于对照组(P<0.05)。结论胎膜早破患者应用预防性抗生素治疗可有效延长孕周,降低剖宫产与早产风险,改善新生儿出生条件,对母婴结局具有积极改善作用。

Objective To study the effect of prophylactic antibiotic therapy on intrauterine infection and maternal and infant outcomes in patients with premature rupture of membranes.Methods Sixty pregnant women with premature rupture of membranes admitted to Longnan First People's Hospital from January 2020 to December 2022 were selected and divided into control group(30 pregnant women)and observation group(30 pregnant women)according to random number table method.The observation group was treated with prophylactic antibiotics,while the control group was not treated with antibiotics.The gestational weeks of delivery,postpartum hemorrhage,postpartum hospitalization time,perinatal outcomes(vaginal delivery,cesarean section,premature delivery),maternal outcomes(chorioamnionitis,intrauterine infection,puerperal infection,postpartum hemorrhage),neonatal birth(neonatal body weight,neonatal Apgar score),neonatal outcomes(neonatal respiratory distress,neonatal pneumonia,neonatal meningitis,neonatal sepsis,death)were compared between the two groups.Results The gestational week of delivery in the observation group was later than that in the control group,the postpartum hemorrhage was shorter than that in the control group,and the postpartum hospitalization time was shorter than that in the control group(P<0.05).The vaginal delivery rate of the observation group was higher than that of the control group,and the cesarean section rate and premature delivery rate were lower than those of the control group(P<0.05).The incidence of adverse outcomes in the observation group was lower than that in the control group(P<0.05).The neonatal body weight and neonatal Apgar score in the observation group were higher than those in the control group(P<0.05).The incidence of neonatal adverse outcomes in the observation group was lower than that in the control group(P<0.05).Conclusion Prophylactic antibiotic therapy in patients with premature rupture of membranes can effectively prolong gestational weeks,reduce the risk of cesarean section and premature delivery,improve neonatal birth conditions,and have a positive effect on maternal and infant outcomes.