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目的 了解孕妇宫颈状况和早产治疗对妊娠结局的影响。 方法 回顾性分析我院 5年 433例早产病例。 结果 早产发生率为 5 .2 % ,其中胎膜早破 (PPROM)、妊高征 (PIH)导致的早产分别占 41.6 %和 2 7.1%。硫酸镁与沙丁胺醇 (舒喘灵 )联合用药治疗先兆早产 ,延长孕周的时间(8d)长于单独应用硫酸镁 (2 d)。PPROM超过 2 4h者 6 8例 ,发生宫内感染 2 1例 ,破膜 2 4h以内 112例 ,仅有 1例宫内感染 (P<0 .0 0 1)。宫颈细菌培养阳性 2 4例中 ,发生临床宫内感染 13例 ,培养阴性2 2例中有 5例宫内感染 (P<0 .0 5 )。难产组新生儿颅内出血 (ICH)发生率 18.3% (34 / 186例 )高于顺产组 9.5 6 % (2 4/ 2 5 1例 ) (P<0 .0 5 )。 RDS的发生率在 <34周组 (5 .88% )明显高于≥ 34周组(0 .6 0 % ) (P<0 .0 1)。 结论 PPROM超过 2 4h,宫内感染的发生率增加 ;联合应用硫酸镁和沙丁胺酸治疗先兆早产可延长孕周。
Objective To understand the effect of prenatal cervical status and preterm delivery on pregnancy outcome. Methods Retrospective analysis of our hospital 433 cases of preterm birth in 5 years. Results The incidence of preterm birth was 5.2%, of which premature rupture of membranes (PPROM) and PIH accounted for 41.6% and 21.1%, respectively. Magnesium sulfate and salbutamol (salbutamol) combined treatment of threatened preterm labor, extended gestational age (8d) longer than magnesium sulfate alone (2d). There were 68 cases with PPROM more than 24 hours, 21 cases with intrauterine infection, 112 cases within 24 hours after rupture of membranes, and only 1 intrauterine infection (P <0.01). Among 24 cases of cervical bacterial culture, 13 cases were clinical intrauterine infection and 5 cases were intrauterine infection (P <0.05). The incidence of intracranial hemorrhage (ICH) in the refractory group was 18.3% (34 of 186 cases) higher than that of the 95.6% (24/251 cases) of the spontaneous group (P <0.05). The incidence of RDS was significantly lower in <34 weeks (5.88%) than in ≥34 weeks (0.06%) (P <0.01). Conclusion PPROM more than 24h, the incidence of intrauterine infection increased; combination of magnesium sulfate and salbutamol treatment of threatened premature delivery can extend gestational age.