妊娠合并急性肾盂肾炎52例临床分析

摘要

目的：探讨妊娠合并急性肾盂肾炎的病原学特点、致病菌构成及治疗转归．方法：对陕西省镇安县县医院2013-06／2014-06收治的52例妊娠合并急性肾盂肾炎患者临床资料进行回顾性分析．结果：本组患者中孕早期发病5例，占9．62％；孕中期发病27例，占51．92％；孕晚期发病20例，38．46％．37例检出菌中，杆菌共31例，球菌6例．药物敏感试验显示氨苄青霉素耐药率较高，达到28例（75．68％），其次为复方新诺明耐药率，为 1 8例（48．65％），头孢菌类耐药率较低，其中头孢西丁耐药率为 1 1例（29．73％），对头孢噻肟耐药率为9例（24．32％））．经对症治疗，本组52例患者治愈48例，4例患者自行出院，预后不明确．结论：妊娠合并急性肾盂肾炎在孕中期发病率最高，致病菌以大肠杆菌为主，头孢菌类药物耐药率较低，药物安全性较高，可作为首选抗生素．%AIM:To study the etiological characteristics and pathogenic bacteria composition and treatment outcomes of preg-nant women with acute pyelonephritis.METHODS:52 cases of pregnant women with acute pyelonephritis were treated from Zhen'an County Hospital of Shaanxi from June 201 3 to June 201 4, and clinical data were retrospectively analyzed.RESULTS:Early pregnancy in this group of patients of 5 cases,accounting for 9.62%;second trimester incidence of 27 cases,accounting for 51 .92%;third trimester incidence of 20 cases,38.46%.Bacte-ria detected in 37 cases,a total of 31 cases of bacilli,cocci 6 ca-ses.Drug sensitivity test showed a higher rate of ampicillin resist-ance reached 28 cases (75.68%),followed by co-trimoxazole re-sistance rate of 1 8 cases (48.65%),lower rates of cephalospo-rin-resistant fungi (cefoxitin resistance rate of 1 1 cases (29.73%),cefotaxime resistance was 9 cases (24.32%).After symptomatic treatment,in this group of 52 patients,48 cases were cured,and 4 cases of patient self-discharge prognosis is not clear. CONCLUSION:Pregnant women with acute pyelonephritis have highest incidence in the second trimester,mainly E.coli bacteri-a,fungi cephalosporin has low drug resistance rate and high drug safety,can be used as the first choice of antibiotics.