未足月胎膜早破时间与组织学绒毛膜羊膜炎相关性分析

Correlation analysis between premature rupture time of fetal membranes and histological chorionic amnionitis

目的分析未足月胎膜早破(PPROM)时间与组织学绒毛膜羊膜炎(HCA)的相关性。方法将2016年2月至2018年2月广东省惠州市第二妇幼保健院产科收治的84例妊娠28~33周胎膜早破患者按胎膜早破时间分为三组,A组(胎膜早破时间<24 h)38例,B组(24 h<胎膜早破时间<48 h)31例,C组(胎膜早破时间>48 h)15例,统计三组患者HCA检出率、HCA病理分期及新生儿并发症的差异,用Spearman相关性系数分析PPROM时间与HCA发生率以及HCA病理分期的关系。结果 84例患者中62例发生HCA,发生率为73.81%,HCA发生率、HCA病理分期均随着胎膜早破时间延长有增高和加重趋势,其中B组和C组发生率、HCA病理分期均高于A组,差异有统计学意义(P<0.05),但B组和C组之间差异均无统计学意义(P>0.05)。PPROM胎膜早破时间与HCA病理分期呈正相关(r=0.302,P<0.05)。新生儿出生体重、出生孕周、出生1 min Apgar评分、并发症与胎膜早破时间均无相关性(P均>0.05)。结论 PPROM患者破膜至分娩时间越长,HCA的发生率越高,HCA病理分期越重,但胎膜早破时间超过48 h HCA增长率和恶化程度逐渐缓和,PPROM早破时间延长并不增加新生儿并发症的风险。

Objective To analyze the correlation between preterm premature rupture of membrane(PPROM)andhistological chorionic amnionitis(HCA).Methods From February 2016 to February 2018,84 cases of PPROM at 28~33 weeks of gestation admitted by the obstetrics department of Huizhou No.2 Women’s and Children’s Healthcare Hospital weredivided into three groups according to the time of premature rupture of membranes:group A(the time of premature ruptureof membranes<24 h)38 cases,group B(24 h<the time of premature rupture of membranes<48 h)31 cases,and group C(the time of premature rupture of membranes>48 h)15 cases.The differences of HCA detection rate,HCA pathologicalstaging and neonatal complications were analyzed.The relationship between the time of PPROM and HCA incidence andHCA pathological staging was analyzed by using Spearman’s rank correlation coefficient analysis.Results Among 84 patients,62 suffered from HCA,and the incidence was 73.81%.The incidence of HCA and the histopathological stages ofHCA increased with the prolonged latency(P<0.05).Both the incidence of HCA and the histopathological stages of group Band group C were higher than group A(P<0.05),but there was no statistically significant difference between group B andgroup C(P>0.05).The time of PPROM was positively correlated with the pathological staging of HCA(r=0.302,P<0.05).Birth weight,gestational weeks and the Apgar score at birth 1 min and neonatal complications were not correlated with thethe time of premature rupture of membranes(P>0.05).Conclusion The longer the duration of membrane rupture tochildbirth in PPROM patients,the higher was the incidence of HCA and the heavier the pathological stage of HCA.However,when the time of premature rupture of membranes exceeded 48 h,the growth rate and deterioration degree ofHCA gradually eased.Meanwhile,the latency of the time of premature rupture of membranes did not increase the risk ofneonatal complications.