不同分娩方式对产后血清C-反应蛋白影响的对比研究

摘要

Objective:To discuss and compare the changing rule of post-delivery serum C-reactive protein(CRP) and analyze the effect of different delivery types on CRP concentration. Method:A retrospective review of 250 maternity patients who delivered in our hospital from October 2012 to August 2013 were conducted,115 of them underwent vaginal delivery whereas 135 cases received cesarean section. The volume of intraoperative bleeding,time of operation,body temperature and blood routine tests of 48 hours after surgery were recorded meanwhile CRP concentration of preoperative 24 hours,intraoperative time,postoperative 24 hours,48 hours,72 hours and 96 hours were also collected,then these clinical data were analyzed combined with clinical history. Result:The volume of intraoperative bleeding in the cesarean section group was obviously more than that in the vaginal delivery group(P<0.01),the rate of infection after delivery was higher than that in the vaginal delivery group(P<0.05). Besides the neutrophil count and body temperature of 48 hours after surgery in the cesarean section group were higher than that in the vaginal delivery group(P<0.01),CRP concentration of the two groups gradually increased after childbirth,the both were much higher than the preoperative value(P<0.01),CPR concentration of the vaginal delivery group gradually decreased after postpartum 72 hours whereas CPR concentration of the cesarean section group gradually declined after postpartum 96 hours,and CRP concentration of the cesarean section group was higher than that in the vaginal delivery group in deferent period after delivery(P<0.01). Conclusion:Delivery type is the important factor that influences postpartum serum CRP concentration,measurement of postpartum serum CRP concentration has great significance in the choice of delivery type and clinical treatment.%目的：讨论比较不同分娩方式分娩后血清C-反应蛋白（C-reactive protein，CPR）的浓度指标变化规律，分析对血清CRP水平影响的相关因素。方法：回顾性选取2012年10月-2013年8月本院妇产科分娩的产妇250例，其中经阴道分娩115例，剖宫产135例，测量产妇术中出血、手术时间、产后48 h体温及血常规等，同时测量产妇分娩前24 h、分娩时、分娩后24、48、72、96 h的CRP浓度，然后结合其临床资料进行分析。结果：剖宫产组术中出血量明显多于经阴道分娩组（P<0.01），产后感染率高于阴道分娩组（P<0.05）；剖宫产组术后48 h中性粒细胞及体温明显高于经阴道分娩组（P<0.01）；两组分娩后CRP浓度逐渐升高，较分娩前水平有显著增高（P<0.01）；CRP在经阴道分娩后72 h开始降低，而在剖宫产分娩后96 h开始降低，剖宫产组分娩后不同时期CRP浓度均高于经阴道分娩组（P<0.01）。结论：分娩方式是产后血清CRP变化的重要影响因素，产后测量CRP对科学的选择分娩方式及临床治疗有重要参考意义。