破膜后头孢唑林治疗对孕晚期B族链球菌感染患者血清炎症因子及凝血功能的影响

Effect of Cefazolin Treatment after Rupture of Membranes on Serum Inflammatory Factors and Coagulation Function in Patients with Group B Streptococcal Infection in Late Pregnancy

目的:探究破膜后头孢唑林治疗对孕晚期B族链球菌感染患者血清炎症因子及凝血功能的影响。方法:选取2021年6月—2023年6月阳江市妇幼保健院收治的100例孕晚期B族链球菌感染患者,用信封法将患者分为两组,每组50例。两组均给予对症分娩干预,破膜后,对照组患者使用青霉素治疗,研究组使用头孢唑林治疗。对两组血清炎症因子水平、凝血功能因子水平、产后相关指标、孕妇不良事件及新生儿结局进行记录。结果:治疗前,对照组和研究组白细胞计数、白介素-6及降钙素原水平比较,差异均无统计学意义(P>0.05);治疗后,两组各项指标均降低,研究组均低于对照组,差异均有统计学意义(P<0.05)。治疗前对照组与研究组凝血酶原时间、国际标准化比率、活化部分凝血活酶时间及凝血酶时间比较,差异均无统计学意义(P>0.05);治疗后,研究组患者凝血酶原时间、活化部分凝血活酶相较于治疗前均延长,研究组均长于对照组,国际标准化比率升高,研究组高于对照组,差异均有统计学意义(P<0.05)。研究组和对照组产后出血量比较,差异无统计学意义(P>0.05);研究组恶露时间短于对照组,恶露量均少于对照组,差异均有统计学意义(P<0.05)。研究组与对照组中转剖宫产、分娩时发热、产后发热、绒毛膜羊膜炎、羊水污染、会阴侧切发生率比较,差异均无统计学意义(P>0.05);研究组产褥感染显著低于对照组,差异有统计学意义(P<0.05)。两组新生儿肺炎、新生儿败血症、病理性黄疸、窒息及脑膜炎发生率比较,差异均无统计学意义(P>0.05)。结论:在孕晚期B族链球菌感染的患者中,破膜后使用头孢菌素类抗生素头孢唑林治疗,能够显著降低患者的血清炎症因子水平,改善凝血功能,减少产褥感染的发生,同时不会对新生儿健康产生不良影响。

Objective:To explore the effect of Cefazolin treatment after rupture of membranes on serum inflammatory factors and coagulation function in patients with group B streptococcal infection in late pregnancy.Method:A total of 100 patients with group B streptococcal infection in late pregnancy admitted to Yangjiang Maternal and Child Health Hospital from June 2021 to June 2023 were selected and divided into two groups by envelope method,with 50 cases in each group.Both groups were given symptomatic delivery intervention.After rupture of membranes,the patients in the control group were treated with Benzylpenicillin,and the study group was treated with Cefazolin.Serum inflammatory factors levels,coagulation function factors levels,postpartum related indicators,maternal adverse events and neonatal outcomes were recorded in the two groups.Result:Before treatment,there were no significant differences in leukocyte count,interleukin-6 and calcitonin levels between control group and study group(P>0.05).After treatment,all indexes of both groups were decreased,and those in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in prothrombin time,international standardized ratio,activated partial thrombin time and thrombin time between the control group and the study group(P>0.05).After treatment,the prothrombin time and activated partial thrombin time in the study group were longer than those before treatment,and those in the study group were longer than those in the control group,the international standardized ratio was increased,and that in the study group was higher than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in postpartum blood loss between the study group and the control group(P>0.05).The lochia time of study group was shorter than that of control group,and the lochia volume was less than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidences of transit cesarean section,fever during delivery,postpartum fever,chorionic amnionitis,amniotic fluid contamination and lateral episiotomy between the study group and the control group(P>0.05).The incidence of puerperal infection in the study group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).There were no significant differences in the incidences of neonatal pneumonia,neonatal septicemia,pathological jaundice,asphyxia and meningitis between the two groups(P>0.05).Conclusion:In patients with group B streptococcal infection in late pregnancy,treatment with cephalosporin antibiotic of Cefazolin after rupture of membranes can significantly reduce the levels of serum inflammatory factors in patients,improve coagulation function,reduce the occurrence of amniotic fluid contamination,and do not have adverse effects on newborn health.