目的 探讨瘢痕子宫孕产妇产褥感染的危险因素和病原学.方法 前瞻性收集该院收治的瘢痕子宫孕产妇276例,根据孕产妇产后是否发生产褥感染,分为感染组25例和无感染组(对照组)251例,比较两组孕产妇主要临床特征并分析瘢痕子宫孕产妇产褥感染的危险因素.结果 与对照组比较,感染组孕产妇孕周<37周、凶险型前置胎盘、产后出血、胎膜早破、胎盘早剥、妊娠性高血压和阴道炎既往史等发病率明显增高,差异有统计学意义(P<0.05).多因素logistics回归分析显示瘢痕子宫孕产妇产褥感染的危险因素包括凶险型前置胎盘、产后出血和胎盘早剥.以革兰阴性菌较为常见,占72.00%,最常见的革兰阴性菌为大肠埃希菌(32.00%),最常见的革兰阳性菌为金黄色葡萄球菌(12.00%).结论 凶险型前置胎盘、产后出血和胎盘早剥是瘢痕子宫孕产妇产褥感染的危险因素,病原菌以革兰阴性菌较为常见.%Objective To investigate the risk factors and etiology of puerperal infection in pregnant women with scar uterus.Methods 276 cases of uterine scar pregnant women were prospectively collected in the hos-pital,according to the development of postpartum puerperal infection or not,all pregnant women were divided into an infection group(n=25)or a non infection group(control group)(n=251).The main clinical features between the two groups were compared and the risk factors of puerperal infection in pregnant women with u-terine scar were analyzed.Results Compared with the control group,the incidence of gestational <37 weeks, perilous placenta previa,postpartum hemorrhage,premature rupture of membranes,placental abruption,preg-nancy induced hypertension and the past history of vaginitis was significantly higher in the infection group,and the difference was statistically significant(P< 0.05).Multivariate logistics regression analysis showed that the risk factors of puerperal infection in pregnant women with scarred uterus included dangerous placenta pre-via,postpartum hemorrhage and placental abruption.Gram negative bacteria were more common,accounting for 72.00%,the most common gram negative bacteria were Escherichia coli(32.00%),the most common gram positive bacteria were Staphylococcus aureus(12.00%).Conclusion Dangerous placenta previa,post-partum hemorrhage and placental abruption are the risk factors of puerperal infection in pregnant women with uterine scar,and Gram negative bacteria are common pathogens.
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