CAJ | 학술논문

目的：回顾性分析足月胎膜早破后残余羊水量对妊娠结局的影响。方法收集143例足月胎膜早破孕产妇临床资料，根据产前B超检测的残余羊水指数（AFI）分为三组：A组（8 cm≤AFI＜25 cm）75例，B组（5 cm≤AFI＜8 cm）38例，C组（ AFI＜5 cm ）30例，比较三组孕妇在分娩方式、宫内感染率、胎儿窘迫率、新生儿发病率和羊水粪染率等方面的差异。结果 C组剖宫产率高于A组（70．00％vs 37．30％，P＜0．05）；A组自然分娩率高于B组和C组，差异均有统计学意义（ P＜0．05）。 C组宫内感染发生率、新生儿疾病发生率、羊水粪染率、胎儿窘迫发生率均高于A组，差异有统计学意义（P＜0．05），其他组间比较均无统计学差异。 Logistic回归分析表明，残余羊水量（OR＝2．912）、破膜至分娩时间（OR＝2．356）与羊水粪染（ OR＝1．833）是产妇宫内感染率、新生儿疾病发病率的影响因素。结论足月胎膜早破后残余羊水量的多少与妊娠结局密切相关，羊水残余量越少对母婴的威胁越大。
목적：회고성분석족월태막조파후잔여양수량대임신결국적영향。방법수집143례족월태막조파잉산부림상자료，근거산전B초검측적잔여양수지수（AFI）분위삼조：A조（8 cm≤AFI＜25 cm）75례，B조（5 cm≤AFI＜8 cm）38례，C조（ AFI＜5 cm ）30례，비교삼조잉부재분면방식、궁내감염솔、태인군박솔、신생인발병솔화양수분염솔등방면적차이。결과 C조부궁산솔고우A조（70．00％vs 37．30％，P＜0．05）；A조자연분면솔고우B조화C조，차이균유통계학의의（ P＜0．05）。 C조궁내감염발생솔、신생인질병발생솔、양수분염솔、태인군박발생솔균고우A조，차이유통계학의의（P＜0．05），기타조간비교균무통계학차이。 Logistic회귀분석표명，잔여양수량（OR＝2．912）、파막지분면시간（OR＝2．356）여양수분염（ OR＝1．833）시산부궁내감염솔、신생인질병발병솔적영향인소。결론족월태막조파후잔여양수량적다소여임신결국밀절상관，양수잔여량월소대모영적위협월대。
Objective To analyze and discuss the impacts of the outcome of pregnancy according to the residual amount of am-niotic fluid after full-term premature rupture of fetalmembranes.Methods 143 puerperas were divided into three groups according to their prenatal B ultrasound detection of residual amniotic fluid index(AFI) results, including Group A (8 cm≤AFI<25 cm) 75 ca-ses,Group B(5 cm≤AFI<8 cm) 38 cases and Group C(AFI <5 cm) 30 cases.Thedifferenceswere comparedbetween the three groups of pregnant women in mode of delivery, intrauterine infection, fetal distress, neonatal morbidity and meconium stained amniotic fluid rate.Results The cesarean section rate in Group C was significantly higher than in Group A (70.00%vs 37.30%,P<0.05). The spontaneous vaginal delivery rates in Group C and Group B were lower than in Group A, with a significant difference(P<0.05). The intrauterine infection rate, the incidence of neonatal disease, the meconium stained amniotic fluid rate and the incidence of fetal distress in Group C were higher than in Group A, with statistically significant difference(P<0.05).The othercomparisonsbetween groups showed no significant difference.From the Logistic regression analysis results of the risk factors on maternal intrauterine infec-tion rate and neonatal morbidity, it was known that the residual amount of amniotic fluid, the time of membranes ruptured till delivery and the meconium stained amniotic fluid were the main factors influencing the maternal intrauterine infection rate and neonatal morbidi-ty.Conclusions The residual amount of amniotic fluid after full-term premature rupture of fetal membranes closely relates to the preg-nancy outcome.The less the residual amount of amniotic fluid, the more seriousthe threat of maternal and infant health.