产后宫内感染的影响因素及病原菌分析

发布时间：2018-05-03 20:39

本文选题：产后宫内感染 + 临床特征　；参考：《中华医院感染学杂志》2017年17期

【摘要】：目的分析产后宫内感染的临床特征及病原菌分布,为宫内感染的预防和控制提供客观依据。方法选取2013年3月-2016年12月在医院住院分娩的产妇3 128例为研究对象,统计产后宫内感染的发生率,并对引发宫内感染的危险因素进行单因素和多因素logistic回归分析;分析感染产妇的临床表现及送检标本的病原菌分布。结果 3 128例产妇中共有191例发生宫内感染,感染率为6.11%;单因素分析结果显示,孕期、妊娠期并发症情况、胎膜早破、宫内感染史与产后宫内感染具有相关性(P0.05);多因素logistic回归分析结果显示,妊娠并发症、胎膜早破、宫内感染史是发生产后宫内感染的独立危险因素(χ~2=16.397、28.669、37.036,P0.05);在191例产后宫内感染患者中,最常见的临床症状是发热和恶露不清,发生率分别为83.2%和67.5%;191例宫内感染产妇送检标本中有162例检出病原菌,检出率为84.8%;共分离出209株病原菌,其中,革兰阴性菌99株占47.4%,革兰阳性菌69株占33.0%,真菌41株占19.6%,主要病原菌为大肠埃希菌、表皮葡萄球菌、白假丝酵母,分别占26.8%、18.2%、16.3%。结论产后宫内感染的临床表现、相关因素和病原菌分布均有一定的特征性,临床医师应对具有高危因素的孕产妇给予密切关注和有效干预,从而降低宫内感染对母婴结局的不良影响。
[Abstract]:Objective to analyze the clinical characteristics and pathogenic bacteria distribution of postpartum intrauterine infection and to provide objective basis for prevention and control of intrauterine infection. Methods from March 2013 to December 2016, 3 128 pregnant women who were hospitalized and delivered in hospital were selected as study subjects, the incidence of postpartum intrauterine infection was counted, and the risk factors of intrauterine infection were analyzed by univariate and multivariate logistic regression analysis. The clinical manifestations of infected women and the distribution of pathogenic bacteria were analyzed. Results there were 191 cases of intrauterine infection and the infection rate was 6.11.The results of univariate analysis showed that complications during pregnancy and premature rupture of membranes were found in pregnant women. Multivariate logistic regression analysis showed that pregnancy complications, premature rupture of membranes and history of intrauterine infection were the independent risk factors for postpartum intrauterine infection (蠂 2 16.397 / 28.66937.036). The most common clinical symptoms were fever and lochia, the incidence of which were 83.2% and 67.5%, respectively. 162 of 191 pregnant women with intrauterine infection detected pathogenic bacteria, the detection rate was 84.80.209 strains of pathogenic bacteria were isolated. 99 Gram-negative bacteria accounted for 47.4%, 69 Gram-positive bacteria accounted for 33.0, and 41 fungi accounted for 19.60.The main pathogens were Escherichia coli, Staphylococcus epidermidis and Candida albicans, which accounted for 26.818.2% and 16.3B, respectively.The main pathogens were Escherichia coli, Staphylococcus epidermidis and Candida albicans. Conclusion the clinical manifestations of postpartum intrauterine infection, related factors and the distribution of pathogenic bacteria have some characteristics. Clinicians should pay close attention to the pregnant women with high risk factors and intervene effectively. So as to reduce the adverse effects of intrauterine infection on maternal and infant outcomes.
【作者单位】：海南省妇幼保健院产科;海南省妇幼保健院妇保科;海南省妇幼保健院护理部;
【分类号】：R714.46

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