妊娠晚期B族链球菌带菌者敏感抗生素预防性治疗时机的选择及比较
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摘要
目的:探究妊娠晚期B族链球菌(GBS)带菌者敏感抗生素预防性治疗时机的选择及对临床治疗结果的影响。方法:选取2016年7月-2017年7月本院收治的妊娠晚期GBS检测阳性者180例作为研究对象,其中未接受任何治疗者60例设置为A组,在孕35～37周时给予抗生素预防性治疗者60例设置为B组,在临产或胎膜早破时给予抗生素治疗者60例设置为C组。分别观察三组间两两比较的妊娠结局,包括胎膜早破、早产、宫内感染、新生儿感染、产褥感染及剖宫产情况。结果:B、C组的胎膜早破、早产、宫内感染、新生儿感染、产褥感染及剖宫产情况均明显优于A组,差异均有统计学意义(P<0.05)。B、C组胎膜早破、早产、宫内感染、新生儿感染情况比较,差异均无统计学意义(P>0.05);但C组产褥感染、剖宫产情况均明显低于B组,差异均有统计学意义(P<0.05)。结论:临床对妊娠晚期GBS带菌者在临产或胎膜早破时给予敏感抗生素预防性治疗能够显著提高妊娠结局。
Objective:To explore the selection of time for prophylactic treatment of sensitive antibiotics for group B streptococcal(GBS)carriers in the late pregnancy and its effect on the outcome of clinical treatment.Method:A total of 180 cases of GBS positive in the late pregnancy admitted in our hospital from July 2016 to July 2017 were selected as the research objects.60 cases of them did not received any treatment as group A,60 cases were given antibiotic prophylactic treatment at 35-37 weeks of pregnancy as group B and 60 cases were given antibiotic treatment at the time of parturient or premature rupture of membranes as group C.Premature rupture of membranes,premature delivery,intrauterine infection,neonatal infection,puerperal infection and cesarean section pregnancy outcomes of two-to-two comparisons among the three groups were observed.Result:The premature rupture of membranes,premature delivery,intrauterine infection,neonatal infection,puerperal infection and cesarean section in group B and C were significantly better than those in group A,the differences were statistically significant(P<0.05).There were no significant differences in premature rupture of membranes,premature delivery,intrauterine infection and neonatal infection between group B and C(P>0.05);but the puerperal infection and cesarean section in group C were significantly lower than those in group B,the differences were statistically significant(P<0.05).Conclusion:The prophylactic treatment with sensitive antibiotics for GBS carriers in the late pregnancy at the time of parturient or premature rupture of the membranes can significantly improve pregnancy outcomes.
Objective:To explore the selection of time for prophylactic treatment of sensitive antibiotics for group B streptococcal(GBS)carriers in the late pregnancy and its effect on the outcome of clinical treatment.Method:A total of 180 cases of GBS positive in the late pregnancy admitted in our hospital from July 2016 to July 2017 were selected as the research objects.60 cases of them did not received any treatment as group A,60 cases were given antibiotic prophylactic treatment at 35-37 weeks of pregnancy as group B and 60 cases were given antibiotic treatment at the time of parturient or premature rupture of membranes as group C.Premature rupture of membranes,premature delivery,intrauterine infection,neonatal infection,puerperal infection and cesarean section pregnancy outcomes of two-to-two comparisons among the three groups were observed.Result:The premature rupture of membranes,premature delivery,intrauterine infection,neonatal infection,puerperal infection and cesarean section in group B and C were significantly better than those in group A,the differences were statistically significant(P<0.05).There were no significant differences in premature rupture of membranes,premature delivery,intrauterine infection and neonatal infection between group B and C(P>0.05);but the puerperal infection and cesarean section in group C were significantly lower than those in group B,the differences were statistically significant(P<0.05).Conclusion:The prophylactic treatment with sensitive antibiotics for GBS carriers in the late pregnancy at the time of parturient or premature rupture of the membranes can significantly improve pregnancy outcomes.
引文
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[14]马爽,张晓静,李海娇.妊娠晚期B族链球菌带菌者预防性治疗的临床研究[J].医学研究杂志,2014,43(1):111-113.
[15]陈小平,王惠姣,俞北伟,等.B族链球菌产前筛查在母婴感染防控中的应用[J].检验医学,2016,31(4):266-269.
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[17]唐江萍,邓娟,奚杰,等.妊娠晚期B族链球菌感染对孕妇阴道清洁度及不良妊娠结局的影响[J].中国临床医学,2017,24(1):56-59.
[18]张淑珍,金卓杏,陈晓方,等.晚期妊娠孕妇B族链球菌感染状况及妊娠结局分析[J].中华医院感染学杂志,2017,27(12):2801-2804.
[19]许媛媛,陈红波,孟祥莲,等.围生期B族链球菌感染对足月孕妇妊娠结局的影响[J].蚌埠医学院学报,2016,41(12):1651-1654.
[20]张聪颖,汪洁,刘晓芳,等.妊娠晚期生殖道B族链球菌感染对妊娠结局的影响探讨[J].中国性科学,2017,26(2):116-119.
[21]梁梅芬,陈世荣,刘春兰,等.孕晚期生殖道B族链球菌感染的临床干预及新生儿结局分析[J].中国医学创新,2018,15(10):130-132.
[2]尉建霞,范玲,陈雪.孕晚期B族链球菌带菌者母儿结局及高危因素分析[J].中国妇幼健康研究,2016,27(1):81-83.
[3]黄晓玲,林云霞,梁敏洪,等.妊娠晚期妇女B族链球菌带菌情况与母婴预后的关系[J].中国计划生育和妇产科,2015,7(10):45-47.
[4]陈泳言,陆少颜.孕妇生殖道B族溶血性链球菌对母婴预后的影响分析[J].中国医学创新,2017,14(1):94-96.
[5]王茜,马良坤,宋英娜,等.妊娠晚期B族链球菌感染的筛查方法及妊娠结局分析[J].中华医学杂志,2016,96(15):1188-1191.
[6]赵江红,余艳萍,谭琴,等.196例孕妇妊娠晚期B族链球菌带菌与妊娠结局分析[J].中国生育健康杂志,2016,27(5):453-454.
[7]朱李登,蔡丽平,黄庆凤,等.妊娠晚期妇女B族链球菌带菌与妊娠结局的相关性研究[J].检验医学与临床,2017,14(24):3688-3691.
[8]陈海迎,郑建琼,陈晶晶,等.妊娠晚期B族链球菌感染对妊娠结局的影响[J].中国卫生检验杂志,2017,27(18):2611-2613.
[9]吉地阿依,马健,童闻,等.孕晚期孕妇B族链球菌带菌情况和危险因素及应用抗生素预防性治疗对母婴结局的影响[J].实用临床医药杂志,2017,21(19):194-196.
[10]徐一鸣,韩宁,刘琰,等.孕妇生殖道B族链球菌感染对妊娠结局的影响研究[J].中华医院感染学杂志,2016,26(9):2128-2130.
[11]Fischer R L,Parikh L,Hansen C,et al.Cervical dilatation thresholds for initiation of group B streptococcus antibiotic prophylaxis for women with spontaneous preterm labor[J].J Matern Fetal Neonatal Med,2015,28(16):1901-1906.
[12]褚利霞.妊娠晚期孕妇生殖道B族链球菌感染对母婴预后影响[J].中国妇幼保健,2016,31(24):5361-5362.
[13]孙丹华,李宣,杨翠芳,等.妊娠晚期B族链球菌带菌状况分析及其对妊娠结局的影响[J].中国综合临床,2014,36(7):764-767.
[14]马爽,张晓静,李海娇.妊娠晚期B族链球菌带菌者预防性治疗的临床研究[J].医学研究杂志,2014,43(1):111-113.
[15]陈小平,王惠姣,俞北伟,等.B族链球菌产前筛查在母婴感染防控中的应用[J].检验医学,2016,31(4):266-269.
[16]Turrentine M A,Greisinger A J,Brown K S,et al.Duration of intrapartum antibiotics for group B streptococcus on the diagnosis of clinical neonatal sepsis[J].Infect Dis Obstet Gynecol,2013,2013(1):525878.
[17]唐江萍,邓娟,奚杰,等.妊娠晚期B族链球菌感染对孕妇阴道清洁度及不良妊娠结局的影响[J].中国临床医学,2017,24(1):56-59.
[18]张淑珍,金卓杏,陈晓方,等.晚期妊娠孕妇B族链球菌感染状况及妊娠结局分析[J].中华医院感染学杂志,2017,27(12):2801-2804.
[19]许媛媛,陈红波,孟祥莲,等.围生期B族链球菌感染对足月孕妇妊娠结局的影响[J].蚌埠医学院学报,2016,41(12):1651-1654.
[20]张聪颖,汪洁,刘晓芳,等.妊娠晚期生殖道B族链球菌感染对妊娠结局的影响探讨[J].中国性科学,2017,26(2):116-119.
[21]梁梅芬,陈世荣,刘春兰,等.孕晚期生殖道B族链球菌感染的临床干预及新生儿结局分析[J].中国医学创新,2018,15(10):130-132.