疤痕子宫患者再次剖宫产术后产褥感染的危险因素与病原学和耐药性分析

发布时间：2018-12-15 01:41

【摘要】：目的探讨疤痕子宫患者再次剖宫产术后产褥感染的危险因素、病原学和耐药性,为临床治疗提供参考依据。方法自2015年1月-2016年6月前瞻性收集医院收治的疤痕子宫再次行剖宫产术的孕产妇382例,分析疤痕子宫患者再次剖宫产术后产褥感染的发生率、危险因素、病原学和耐药性。结果 382例孕产妇,共31例发生产褥感染,感染率为8.12%;多因素回归分析显示,凶险型前置胎盘、凶险型前置胎盘合并胎盘植入、产后出血和孕产妇阴道炎是疤痕子宫患者再次剖宫产术后产褥感染的独立危险因素(P0.05);共培养出26株病原菌,以革兰阴性菌为主,占65.38%,革兰阴性菌耐药率最高的是头孢他啶,为41.18%。结论疤痕子宫患者再次剖宫产术后产褥感染率较高,凶险型前置胎盘、凶险型前置胎盘合并胎盘植入、产后出血和孕产妇阴道炎是高危因素,革兰阴性菌较为常见,对青霉素和头孢他啶耐药率较高。
[Abstract]:Objective to investigate the risk factors, etiology and drug resistance of puerperal infection after cesarean section in patients with scar uterus. Methods from January 2015 to June 2016, 382 pregnant women with scar uterus undergoing cesarean section were collected prospectively. The incidence, risk factors, etiology and drug resistance of puerperal infection after cesarean section in patients with scar uterus were analyzed. Results among 382 pregnant and parturient women, 31 cases had puerperal infection and the infection rate was 8.12%. Multivariate regression analysis showed that severe placenta previa with placenta accreta postpartum hemorrhage and maternal vaginitis were independent risk factors of puerperal infection after cesarean section in patients with scar uterus (P0.05). A total of 26 strains of pathogenic bacteria were cultured, mainly Gram-negative bacteria (65.38). The highest resistance rate of Gram-negative bacteria was ceftazidime (41.18). Conclusion the puerperal infection rate of the patients with scar uterus after cesarean section is high, the dangerous placenta previa with placenta accreta, postpartum hemorrhage and vaginitis of pregnant women are high risk factors, Gram-negative bacteria are more common. The resistance to penicillin and ceftazidime was higher.
【作者单位】：缙云县妇幼保健院保健科;缙云县人民医院妇产科;缙云县妇幼保健院围产保健科;
【基金】：浙江省医药卫生一般研究计划基金(2014KYB241)
【分类号】：R714.6

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