CAJ | 학술논문

目的：探讨C反应蛋白在产后产褥感染患者血清中的表达水平及其在产褥感染诊断中的临床意义。方法随机选取2012年10月～2013年8月孕妇3800例，其中采用阴道分娩方式1710例（A组），采用剖宫产方式分娩2090例（B组）。监测两组产前1 d及产后7 d内白细胞计数（WBC计数）、C反应蛋白以及48 h体温变化。对两组不同分娩方式产后产褥感染率进行对比分析，并对产褥感染病例及无感染病例产后1、3、5、7 d内的C反应蛋白水平变化加以监测。结果采用阴道分娩方式以及剖宫产方式分娩产后WBC计数和C反应蛋白的变化水平显著高于产前水平；阴道方式分娩产后产褥感染率为1.42%（24例），而剖宫产方式分娩产后产褥感染率高达6.96%（136例），剖宫产方式分娩产后产褥感染率高于阴道方式分娩，差异具有统计学意义（P＜0.05）；与无产褥感染病例比较，产褥感染病例在产后1 d C反应蛋白水平开始迅速升高，第3天达到高峰，5～7d后开始降低，但都高于正常水平。结论剖宫产分娩可增加孕妇产后产褥感染率，在产褥感染患者血清C反应蛋白水平迅速升高，对孕妇产后产褥感染的早期发现及诊断有重要意义。
목적：탐토C반응단백재산후산욕감염환자혈청중적표체수평급기재산욕감염진단중적림상의의。방법수궤선취2012년10월～2013년8월잉부3800례，기중채용음도분면방식1710례（A조），채용부궁산방식분면2090례（B조）。감측량조산전1 d급산후7 d내백세포계수（WBC계수）、C반응단백이급48 h체온변화。대량조불동분면방식산후산욕감염솔진행대비분석，병대산욕감염병례급무감염병례산후1、3、5、7 d내적C반응단백수평변화가이감측。결과채용음도분면방식이급부궁산방식분면산후WBC계수화C반응단백적변화수평현저고우산전수평；음도방식분면산후산욕감염솔위1.42%（24례），이부궁산방식분면산후산욕감염솔고체6.96%（136례），부궁산방식분면산후산욕감염솔고우음도방식분면，차이구유통계학의의（P＜0.05）；여무산욕감염병례비교，산욕감염병례재산후1 d C반응단백수평개시신속승고，제3천체도고봉，5～7d후개시강저，단도고우정상수평。결론부궁산분면가증가잉부산후산욕감염솔，재산욕감염환자혈청C반응단백수평신속승고，대잉부산후산욕감염적조기발현급진단유중요의의。
Objective To investigate the expression level of C-reactive protein(CRP)in the serum of patients with puerperal infection and its clinical significance in the diagnosis of puerperal infection. Methods 3 800 pregnant women in our hospital were randomly selected. According to the mode of delivery, 3 800 pregnant women were divided into two groups:one was vaginal delivery group(1710 cases), and the other was cesarean section group(2090 cases). The patients’temperature in 48 hours were monitored. The White blood cell count(WBC)and CRP level in the serum of all the patients were detected at one day before delivery, the first, third, fifth and seventh after delivery. Then compared the indices of the two groups and figured out the chang of CRP level in the patients with(or without)puerperal infection. Results The WBC and CRP level of Postnatal patients in two groups were significantly higher prenatal levels. Vaginal delivery group postpartum puerperal infection rate was 1.42%(24 cases), and cesarean section group postpartum puerperal infection rate was 6.96%(136 cases), puerperal infection rate of cesarean section group was significantly higher than the vaginal delivery group(P<0.05). Compared with patients without infection, Serum C-reactive protein level of patients’with puerperal infection began to rise rapidly at the first day after delivery, and had been highest at the third day, and then began to decrease. Conclusion The cesarean delivery can increase maternal postpartum puerperal infection, serum C-reactive protein level in patients with puerperal infection increase rapidly, which is important in the early postpartum and diagnosis with puerperal infection in pregnant women.