临床路径在B族链球菌感染合并足月胎膜早破产妇中的应用研究

发布时间：2018-02-14 09:20

本文关键词： 胎膜早破临床路径 B族溶血性链球菌　出处：《中国全科医学》2017年21期 　论文类型：期刊论文

【摘要】：目的评价临床路径在B族链球菌(GBS)感染合并足月胎膜早破产妇中的应用效果。方法回顾性选择2011年6月—2015年12月上海交通大学医学院附属国际和平妇幼保健院诊断为GBS感染合并足月胎膜早破产妇311例。2011年6月—2014年6月为临床路径试点阶段,产妇知情后未选择临床路径管理(对照组);2014年7月—2015年12月为临床路径实施阶段,产妇知情后选择临床路径管理(路径组)。比较两组年龄、产次、胎膜早破到分娩时间、阴指检查次数、镇痛分娩情况、抗生素使用情况、引产情况、住院费用、住院天数以及产妇和新生儿不良结局的发生率。结果对照组和路径组年龄、产次、胎膜早破到分娩时间、阴指检查次数、镇痛分娩率、抗生素使用率和引产率比较,差异均无统计学意义(P0.05)。对照组住院费用中位数为4 964.7元,高于路径组的4 336.7元(u=-3.100,P=0.002);两组住院天数间差异无统计学意义(u=-0.960,P=0.336)。对照组产妇感染发生率为7.7%,高于路径组的2.4%(χ~2=4.104,P=0.043);两组新生儿感染、新生儿高胆红素血症、Apgar评分7分发生率比较,差异均无统计学意义(χ~2=0.143、0.041、0.164,P=0.708、0.840、0.694)。结论 GBS感染合并足月胎膜早破产妇通过临床路径管理后,对降低住院费用、产妇感染率均有积极作用。
[Abstract]:Objective to evaluate the clinical effect of clinical pathway in pregnant women with group B streptococcal infection and premature rupture of membranes. Methods retrospective study was conducted from June 2011 to December 2015 in the International Institute of Maternal and Child Health, affiliated to Shanghai Jiaotong University Medical College. There were 311 cases of GBS infection with term premature rupture of membranes. June 2011 to June 2014 was the trial stage of clinical pathway. The pregnant women did not choose the clinical pathway management after knowing (control group); July 2014-December 2015 was the clinical pathway implementation stage. The pregnant women chose the clinical path management after informed (path group). The age, delivery time, premature rupture of fetal membrane to delivery time were compared between the two groups. The number of yinx examinations, analgesic delivery, antibiotic use, induced labor, hospitalization expenses, hospitalization days, and the incidence of maternal and neonatal adverse outcomes. Results the age, delivery time of the control group and path group, There were no significant differences between premature rupture of fetal membrane and delivery time, number of examination of vaginal finger, rate of analgesic delivery, utilization rate of antibiotics and rate of induced labor. The median hospitalization cost of the control group was 4 964.7 yuan. There was no significant difference in hospitalization days between the two groups. The incidence of maternal infection in the control group was 7. 7, which was higher than that in the paw group (蠂 2 / 2, P = 4. 104, P = 0. 043). The incidence of neonatal infection and Apgar score of neonatal hyperbilirubinemia was higher than that in the paw group, and the incidence of Apgar score of neonatal hyperbilirubinemia in the two groups was higher than that in the paw group. There was no significant difference between the two groups (蠂 ~ (2 / 2) 0.143 ~ 0. 041 ~ 0. 164 ~ 0. 708 ~ 0. 708 ~ 0. 40 ~ 0. 6940.Conclusion GBS infection combined with term premature rupture of membranes has a positive effect on reducing hospitalization cost and maternal infection rate after clinical path management.
【作者单位】：上海交通大学医学院附属国际和平妇幼保健院医务科;
【基金】：上海市卫生和计划生育委员会卫生计生政策研究课题项目(自选类)(2016HP029)
【分类号】：R714.433

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