未足月胎膜早破阴道分泌物异常与母儿预后的关系.doc

未足月胎膜早破阴道分泌物异常与母儿预后的关系 作者：黎普茜 单位：东莞市人民医院妇产科，广东 东莞 523018 【摘要】 目的 判断未足月胎膜早破的阴道分泌物结果与母儿预后的关系。方法 将152例未足月胎膜早破 (PPROM) 患者分为阴道分泌物正常组和异常组，分析比较阴道分泌物检测结果及产妇、围产儿的预后情况。结果 PPROM阴道分泌物检查异常率达63.15%(96/152)。PPROM阴道分泌物异常组期待治疗时间较短；发生组织学绒毛膜羊膜炎、胎儿窘迫、新生儿呼吸窘迫综合征 (NRDS)、新生儿感染、剖宫产、产褥感染率均较PPROM阴道分泌正常组升高，两组间差异有显著性(Plt;0.05)。结论 PPROM与宫内感染密切相关，生殖道上行感染是诱发宫内感染的重要原因，且直接影响母儿的预后。孕前及孕期应作阴道分泌物检查，积极治疗阴道炎症。 【关键词】 未足月胎膜早破 阴道分泌物 宫内感 围产儿 Relationship between the Vaginal Secretions during PPROM and the Prognosis of Maternity and Fetus LI Puxi , ZHOU Qianjun ,LI Xuping （Department of Obstetrics and Gynecology, the Peoplersquo;s Hospital of Dong Guan,Dongguan Guangdong 523018, China） ABSTRACT：Objective　To study the relationship between the vaginal secretions during PPROM and the prognosis of precursor and fetus. Methods 152 patients with PPROM were divided into normal vaginal secretion group and abnormal vaginal secretion group, and the result of vaginal secretions, the prognosis of maternality and perinatal fetus. Results The abnormal rate of vaginal secretions during PPROM was about 63.15%(96/152). Compared with mormal vaginal secretions group,the expectation therapy time was shortened and the incidence rates of chorioamnionitis, fetal distress，NRDS, infection of newborn, abdominal delivery, and puerperal infection were increased obviously.A significant difference was observed between normal vaginal secretion group and abnormality vaginal secetion group(P＜0.05) Conclusion There is a close correlation between PPROM and intrauterine infection,whith has a direct effect on the prognosis of maternity and fetus. KEY WORDS:Preterm premature rupture of the membrane;Vaginal secretions;Intrauterine infection;Neonate 未足月胎膜早破(preterm premature rupture of the membrane,PPROM)是指妊娠未满37周胎膜在临产前发生破裂。临床发病率国内报道为2.0%　～3.5%，国外报道为2%～3%，基本一致[1]。PPROM可以引起早产、脐带脱垂、母儿感染,使围产儿病率及胎儿死亡率明显增高。PPROM孕妇中只有7.7%～9.7%的胎膜破口能够自然愈合，而持续阴道流液的孕妇60%在7天内启动分娩[2],及时诊断和有效治疗尤为重要。本文对152例PPROM的阴道分泌物结果进行回顾性分析，旨在探讨其与期待治疗方法及母儿预后关系。 1 资料和方法 1.1 一般资料 分析我院 2