胎膜早破患者发生宫内感染的影响因素分析及防治对策研究

Influencing factors and prevention countermeasures of intrauterine infection in patients with premature rupture of membranes

目的探讨胎膜早破患者发生宫内感染的影响因素及防治对策。方法回顾性分析2019年1月至2021年7月大连市妇女儿童医疗中心(集团)接收的120例胎膜早破患者的临床资料,比较感染及未感染患者白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CPR)水平,采用单因素及多因素Logistic回归分析胎膜早破患者发生宫内感染的影响因素。结果感染与未感染患者年龄、分娩史比较差异无统计学意义;感染患者住院时间长于未感染患者,孕龄大于未感染患者,胎膜早破时间≤1个月、胎膜破膜至分娩时间>12h、瘢痕子宫、破膜后阴道检查次数>4次占比及IL-6、CPR、PCT水平均高于未感染患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,胎膜早破时间≤1个月、胎膜破膜至分娩时间>12h、有瘢痕子宫是胎膜早破患者发生宫内感染的危险因素(P<0.05)。结论胎膜早破时间≤1个月、胎膜破膜至分娩时间>12h、有瘢痕子宫是胎膜早破患者发生宫内感染的危险因素,血清炎症指标可反映患者感染程度,应根据影响因素与预测指标采取对应预防措施,以有效预防宫内感染发生。

Objective To explore the influencing factors and prevention countermeasures of intrauterine infection in patients with premature rup-ture of membranes.Methods The clinical data of 120 patients with premature rupture of membranes in Dalian Women and Children Medical Center(Group)from January 2019 to July 2021 were retrospectively analyzed.The levels of interleukin-6(IL-6),procalcitonin(PCT)and C-reactive protein(CPR)were compared between infection patients and non-infection patients.The influencing factors of intrauterine infection were analyzed by uni-variate and multivariate Logistic regression analysis.Results There was no significant difference in age and delivery history between infection pa-tients and non-infection patients.The hospitalization time of infected patients was longer than that of non-infection patients,gestational age was larg-er than that of non-infection patients,the proportion of premature rupture of membranes≤1 month,the time from rupture of membranes to delivery>12 h,scarred uterus,the number of vaginal examinations>4 times after rupture of membranes,and the levels of IL-6,CPR and PCT were higher than those of non-infection patients,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the time of premature rupture of membranes≤1 month,the time from rupture of membranes to delivery>12 h,and scarred uterus were risk factors for intrauterine infection in patients with premature rupture of membranes(P<0.05).Conclusion The time of premature rupture of membranes≤1 month,the time from rupture of membranes to delivery>12 h,and scarred uterus are risk factors of intrauterine infection in patients with premature rupture of membranes,serum inflammatory indexes can reflect infection severity,the corresponding preventive measures should be taken according to the influencing factors and predictive indexes to effectively prevent intrauterine infection.