中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
7期
764-767
,共4页
孙丹华%李宣%杨翠芳%王李利
孫丹華%李宣%楊翠芳%王李利
손단화%리선%양취방%왕리리
妊娠晚期%B 族链球菌%妊娠结局
妊娠晚期%B 族鏈毬菌%妊娠結跼
임신만기%B 족련구균%임신결국
Late pregnancy%Group B streptococcus%Pregnancy outcome
目的:探讨妊娠晚期 B 族链球菌(GBS)带菌状况以及 GBS 带菌对妊娠结局及围生儿的影响。方法选择妊娠35~37周孕妇520例,取产前阴道下1/3分泌物及肛周分泌物,分娩后胎盘子面和新生儿咽、耳泌物进行 GBS 检测。对带菌状况以及 GBS 带菌对妊娠结局及围生儿的影响进行分析。结果(1)520例孕妇 GBS 阳性检出率为10.19%(53/520)。(2)新生儿 GBS 带菌率为8.85%(46/520)。GBS 阳性母亲的新生儿带菌率(22.64%,12/53)高于阴性母亲(7.28%,34/467),差异有统计学意义(χ2=13.928,P <0.05)。妊娠晚期 GBS 阳性者,其新生儿肺炎(20.75%,11/53)、上呼吸道感染(18.87%,10/53)发生率高于阴性者(8.57%,40/467;4.71%,22/467)。新生儿 GBS 阳性者的肺炎(21.73%,10/46)、上呼吸道感染(19.56%,9/46)发生率高于阴性者(8.65%,41/474;4.85%,23/474),,差异有统计学意义(χ2值分别为8.121、15.717,P 均<0.05)。(3)妊娠晚期 GBS 阳性者胎儿窘迫、宫内感染发生率分别为47.17%(25/53)、15.09%(8/53),显著高于阴性者[分别为7.07%(33/467)、4.71%(22/467)],差异均有统计学意义(χ2值分别为77.248、9.440,P 均<0.05);而胎膜早破、早产发生率 GBS 阳性者分别为28.30%(15/53)、3.77%(2/53),与阴性者[分别为28.48%(133/467)、2.36%(11/467)]比较,差异无统计学意义(χ2值分别为0.001、0.393,P 均>0.05)。妊娠晚期 GBS 阳性者合并霉菌性阴道炎、前置胎盘比例[39.62%(21/53)、7.55%(4/53)]高于阴性者[20.56%(96/467)、1.93%(9/467)],差异均有统计学意义(χ2值分别为9.922、6.168,P 均<0.05)。结论妊娠晚期 GBS 带菌明显增加宫内感染、胎儿窘迫及新生儿感染的发生率,对妊娠结局造成不良影响,应对孕妇常规行 GBS 筛检。
目的:探討妊娠晚期 B 族鏈毬菌(GBS)帶菌狀況以及 GBS 帶菌對妊娠結跼及圍生兒的影響。方法選擇妊娠35~37週孕婦520例,取產前陰道下1/3分泌物及肛週分泌物,分娩後胎盤子麵和新生兒嚥、耳泌物進行 GBS 檢測。對帶菌狀況以及 GBS 帶菌對妊娠結跼及圍生兒的影響進行分析。結果(1)520例孕婦 GBS 暘性檢齣率為10.19%(53/520)。(2)新生兒 GBS 帶菌率為8.85%(46/520)。GBS 暘性母親的新生兒帶菌率(22.64%,12/53)高于陰性母親(7.28%,34/467),差異有統計學意義(χ2=13.928,P <0.05)。妊娠晚期 GBS 暘性者,其新生兒肺炎(20.75%,11/53)、上呼吸道感染(18.87%,10/53)髮生率高于陰性者(8.57%,40/467;4.71%,22/467)。新生兒 GBS 暘性者的肺炎(21.73%,10/46)、上呼吸道感染(19.56%,9/46)髮生率高于陰性者(8.65%,41/474;4.85%,23/474),,差異有統計學意義(χ2值分彆為8.121、15.717,P 均<0.05)。(3)妊娠晚期 GBS 暘性者胎兒窘迫、宮內感染髮生率分彆為47.17%(25/53)、15.09%(8/53),顯著高于陰性者[分彆為7.07%(33/467)、4.71%(22/467)],差異均有統計學意義(χ2值分彆為77.248、9.440,P 均<0.05);而胎膜早破、早產髮生率 GBS 暘性者分彆為28.30%(15/53)、3.77%(2/53),與陰性者[分彆為28.48%(133/467)、2.36%(11/467)]比較,差異無統計學意義(χ2值分彆為0.001、0.393,P 均>0.05)。妊娠晚期 GBS 暘性者閤併黴菌性陰道炎、前置胎盤比例[39.62%(21/53)、7.55%(4/53)]高于陰性者[20.56%(96/467)、1.93%(9/467)],差異均有統計學意義(χ2值分彆為9.922、6.168,P 均<0.05)。結論妊娠晚期 GBS 帶菌明顯增加宮內感染、胎兒窘迫及新生兒感染的髮生率,對妊娠結跼造成不良影響,應對孕婦常規行 GBS 篩檢。
목적:탐토임신만기 B 족련구균(GBS)대균상황이급 GBS 대균대임신결국급위생인적영향。방법선택임신35~37주잉부520례,취산전음도하1/3분비물급항주분비물,분면후태반자면화신생인인、이비물진행 GBS 검측。대대균상황이급 GBS 대균대임신결국급위생인적영향진행분석。결과(1)520례잉부 GBS 양성검출솔위10.19%(53/520)。(2)신생인 GBS 대균솔위8.85%(46/520)。GBS 양성모친적신생인대균솔(22.64%,12/53)고우음성모친(7.28%,34/467),차이유통계학의의(χ2=13.928,P <0.05)。임신만기 GBS 양성자,기신생인폐염(20.75%,11/53)、상호흡도감염(18.87%,10/53)발생솔고우음성자(8.57%,40/467;4.71%,22/467)。신생인 GBS 양성자적폐염(21.73%,10/46)、상호흡도감염(19.56%,9/46)발생솔고우음성자(8.65%,41/474;4.85%,23/474),,차이유통계학의의(χ2치분별위8.121、15.717,P 균<0.05)。(3)임신만기 GBS 양성자태인군박、궁내감염발생솔분별위47.17%(25/53)、15.09%(8/53),현저고우음성자[분별위7.07%(33/467)、4.71%(22/467)],차이균유통계학의의(χ2치분별위77.248、9.440,P 균<0.05);이태막조파、조산발생솔 GBS 양성자분별위28.30%(15/53)、3.77%(2/53),여음성자[분별위28.48%(133/467)、2.36%(11/467)]비교,차이무통계학의의(χ2치분별위0.001、0.393,P 균>0.05)。임신만기 GBS 양성자합병매균성음도염、전치태반비례[39.62%(21/53)、7.55%(4/53)]고우음성자[20.56%(96/467)、1.93%(9/467)],차이균유통계학의의(χ2치분별위9.922、6.168,P 균<0.05)。결론임신만기 GBS 대균명현증가궁내감염、태인군박급신생인감염적발생솔,대임신결국조성불량영향,응대잉부상규행 GBS 사검。
Objective To investigate the group B streptococcus( GBS)colonization rate and the relationship between vaginal colonization of GBS and the pregnancy outcome. Methods Five hundred and twenty cases pregnant women were selected as our subjects. Microbiological culture was used for culture of GBS in 1 / 3 of vagina and rectus before delivery,other samples from different sites after delivery(including neonatal throat,ear and placenta). Results (1)The GBS carrier rate in 520 pregnant women was 10. 19%(53 / 520). (2)GBS carrier rate in neonatal was 8. 85%(46 / 520). The carrier rate of neonatal whose mothers also carried GBS was 22. 64%(12 / 53),higher than that of non-carrier mothers(7. 28%(34 / 467),χ2 = 8. 192,P < 0. 05) . The rate of pneumonia and the upper respiratory tract infection of neonatal with GBS-carrier-mother were 20. 75%(11 / 53)and 18. 87%(10 / 53),higher than that of non-carrier mothers(8. 57%(40 / 467)and 4. 71%(22 / 467)). The pneumonia rate and upper respiratory tract infection of GBS positive neonatal were 21. 73%(10 / 46)and 19. 56%(9 / 46),higher than GBS negative one(8. 65%(41 / 474);4. 85%(23 / 474)). and there were significant differences(χ2 = 8. 121,15. 717;P < 0. 05).(3)The incidence of intrauterine infection and fetal distress of neonatal with GBS( + )mother were 47. 17%(25 / 53),15. 09%(8 / 53),significantly higher than that of negative(7. 07%(33 / 467),4. 71%(22 / 467)),and the differences were statistically significant( χ2= 77. 248,9. 440;P < 0. 05). But there were the similar incidence in term of premature rupture of fetal membranes,premature occurrence rate between GBS positive and negative mothers( 28. 30%( 15 / 53 ) vs. 28. 48%(133 / 467;3. 77%(2 / 53)vs. 2. 36%(11 / 467);χ2 = 0. 001,0. 393;P > 0. 05). The rate of GBS positive with mycotic vaginitis,placenta previa ratio were 39. 62%(21 / 53),7. 55%(4 / 53),higher than that of GBS negative one(20. 56%(96 / 467),1. 93%(9 / 467)),and the differences were statistically significant(χ2= 9. 922,6. 168,P < 0. 05). Conclusion Maternal GBS carrier at 35 - 37 weeks of gestation can lead to adverse pregnancy outcome by increasing intrauterine infection fetal distress and neonatal infections. Screening of GBS should be performed routinely in late gestation.