妊娠36周及以上胎膜早破时抗生素的应用分析

摘要

Objective To explore the influence of antibiotics on maternal-infant outcome in premature rupture of mem-brane at and above 36 weeks of gestation.Methods 84 patients with premature rupture of membrane admitted to hospital from October,2013 to November,2014 were divided into control group(41 cases)and observation group(43 cases).The con-trol group was given sodium intravenous drip of antibiotics to prevent infection,and the observation group were not given anti-biotics.Maternal-infant outcomes like cesarean section,puerperal infection,chorioamnionitis,postpartum hemorrhage and fetal distress,neonatal aspiration pneumonia,neonatal asphyxia and perinatal death,etc.of the two groups were compared.Mean-while,abnormal condition of normal indexes like postpartum body temperature,C-reactive protein(CRP),blood routine and perineum wound infection,etc.were observed between groups.Results Difference of incidence of cesarean section,postpar-tum hemorrhage,fetal distress,neonatal aspiration pneumonia and neonatal asphyxia of the observation group and the control group was not statistically significant(P>0.05).No puerperal infection,chorioamnionitis and perinatal death were found in neither groups.There was no statistically significant difference in abnormal postpartum body temperature,abnormal CRP,ab-normal blood routine and abnormal perineum wound infection in the two groups(P>0.05).Conclusion In the absence of clear cases of infection,there is no effect of the use of antibiotics on the delivery mode and the incidence of maternal and in-fant complications in the 36 weeks of pregnancy or above and the premature rupture of membranes.%目的：探讨妊娠36周及以上胎膜早破时使用抗生素对母婴结局的影响。方法将2013年10月至2014年11月收治的84例胎膜早破患者随机分为两组，对照组41例给予头孢菌素类抗生素静脉滴注预防感染，观察组43例未给予抗生素治疗，比较两组剖宫产、产褥感染、产妇绒毛膜炎、产后出血及胎儿窘迫、新生儿吸入性肺炎、新生儿窒息、围产儿死亡等母婴结局。观察两组产妇产后体温、C-反应蛋白（CRP）、血常规、会阴创口感染等常规指标异常情况。结果观察组剖宫产率及产后出血、胎儿窘迫、新生儿吸入性肺炎、新生儿窒息发生率与对照组比较差异均无统计学意义（P>0.05）。两组均未出现产褥感染、产妇绒毛膜炎、围产儿死亡的情况。观察组体温异常、CRP 异常、血常规异常、会阴创口感染发生率与对照组比较差异均无统计学意义（P>0.05）。结论在无明确感染的情况下，对于妊娠36周及以上胎膜早破是否使用抗生素对分娩方式及母婴并发症发生率并无影响。