中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
22期
54-56,59
,共4页
未足月胎膜早破%期待期%妊娠结局
未足月胎膜早破%期待期%妊娠結跼
미족월태막조파%기대기%임신결국
Preterm premature rupture of the membranes%Latency%Pregnancy outcome
目的：分析不同孕周发生的未足月胎膜早破及其期待期对妊娠结局的影响。方法对2010年1月~2015年4月在我院住院分娩的322例(28~36+6周)PPROM临床病例资料进行分析。按PPROM发生时孕周分成两组：①P28~33+6周；②P34~36+6周。根据期待期是否达到48 h,两组再各分为两个组,分别对比两组不同期待期与妊娠结局的关系。结果孕28~33+6周PPROM组发生绒毛膜炎、胎儿窘迫、新生儿呼吸窘迫综合征均高于孕34~36+6周PPROM组；孕34~36+6周PPROM孕妇,期待期超过48 h组发生绒毛膜炎、产后出血、新生儿感染的比例明显高于期待期在48 h内组。孕28~33+6周PPROM孕妇,期待期超过48 h组发生胎儿窘迫、新生儿窒息均低于期待期在48 h内组；并未增加母儿其他不良反应发生。结论对孕28~33+6周PPROM 可采取促胎肺成熟、抑制宫缩和预防感染处理,尽可能延长期待期48 h以上或34周后终止妊娠；对孕34~36+6周PPROM应尽快终止妊娠。
目的：分析不同孕週髮生的未足月胎膜早破及其期待期對妊娠結跼的影響。方法對2010年1月~2015年4月在我院住院分娩的322例(28~36+6週)PPROM臨床病例資料進行分析。按PPROM髮生時孕週分成兩組：①P28~33+6週；②P34~36+6週。根據期待期是否達到48 h,兩組再各分為兩箇組,分彆對比兩組不同期待期與妊娠結跼的關繫。結果孕28~33+6週PPROM組髮生絨毛膜炎、胎兒窘迫、新生兒呼吸窘迫綜閤徵均高于孕34~36+6週PPROM組；孕34~36+6週PPROM孕婦,期待期超過48 h組髮生絨毛膜炎、產後齣血、新生兒感染的比例明顯高于期待期在48 h內組。孕28~33+6週PPROM孕婦,期待期超過48 h組髮生胎兒窘迫、新生兒窒息均低于期待期在48 h內組；併未增加母兒其他不良反應髮生。結論對孕28~33+6週PPROM 可採取促胎肺成熟、抑製宮縮和預防感染處理,儘可能延長期待期48 h以上或34週後終止妊娠；對孕34~36+6週PPROM應儘快終止妊娠。
목적：분석불동잉주발생적미족월태막조파급기기대기대임신결국적영향。방법대2010년1월~2015년4월재아원주원분면적322례(28~36+6주)PPROM림상병례자료진행분석。안PPROM발생시잉주분성량조：①P28~33+6주；②P34~36+6주。근거기대기시부체도48 h,량조재각분위량개조,분별대비량조불동기대기여임신결국적관계。결과잉28~33+6주PPROM조발생융모막염、태인군박、신생인호흡군박종합정균고우잉34~36+6주PPROM조；잉34~36+6주PPROM잉부,기대기초과48 h조발생융모막염、산후출혈、신생인감염적비례명현고우기대기재48 h내조。잉28~33+6주PPROM잉부,기대기초과48 h조발생태인군박、신생인질식균저우기대기재48 h내조；병미증가모인기타불량반응발생。결론대잉28~33+6주PPROM 가채취촉태폐성숙、억제궁축화예방감염처리,진가능연장기대기48 h이상혹34주후종지임신；대잉34~36+6주PPROM응진쾌종지임신。
Objective To explore the effects of different gestational weeks and latency on pregnancy in preterm prema-ture rupture of membranes. Methods All 322 cases of PPROM (28-36+6 weeks) hospitalized from January 2010 to April 2015 were retrospective studied. All cases were divided into two groups by gestational weeks(1)28-33+6 gesta-tional weeks;(2)34-36+6 gestational weeks;each group was further divided into two subgroups by latency,the analysis on the relationship between pregnant weeks,latency and maternal-neonatal outcome was conducted. Results The inci-dences of chorioamnionitis,fetal distress and NRDS in 28-33+6 weeks group were significantly higher than which in 34-33+6 weeks group. In 34-36+6 weeks of PPROM,the incidences of chorioamnionitis,postpartum hemorrhage and neonatal infection were higher in latency over 48 h group than latency within 48 h group. In 28-33+6 group, the incidences of fetal distress and neonatal asphyxia were lower in group of latency over 48 h than which in group of latency within 48 h. There was no difference of other maternal-neonatal complication incidence between the different latency. Conclusion The suitable measures to treat PPROM of 28-33+6 gestational weeks are uterine contraction inhibition,fetal lung matu-ration promotion, infection prevention, extending lantency over 48 h or terminating pregnancy after 34 gestational weeks. To the patients with PPROM at 34-36+6 gestational weeks,the termination of pregnance promptly is the suitable measure to treat.
