摘要
目的探讨高龄产妇产褥期感染影响因素及血清白细胞介素-6(IL-6)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平。方法回顾性分析2010年1月-2020年1月海南医学院第二附属医院接诊的高龄产妇584例的临床资料,依据是否发生产褥期感染分为对照组552例(未发生产褥期感染)与病例组32例(发生产褥期感染);分析病例组产妇的病原菌,比较两组血清炎性因子水平,归纳高龄产妇产褥期感染影响因素。结果发生产褥期感染32例,感染率为5.48%(32/584),以会阴部感染为主;共培养分离病原菌41株,其中革兰阴性菌27株占65.85%,革兰阳性菌13株占31.71%,真菌1株占2.44%,以大肠埃希菌为主。病例组血清IL-6、PCT、TNF-α水平均高于对照组(P<0.05)。病例组产妇出现产钳/胎头吸引、产道损伤、妊娠期糖尿病的比例高于对照组(P<0.05)。产钳/胎头吸引、产道损伤、妊娠期糖尿病是高龄产妇发生产褥期感染的影响因素(P<0.05)。结论高龄产妇产褥期感染病原菌以大肠埃希菌为主,发生产褥期感染后产妇的各类血清学炎性因子浓度均出现明显升高,诱导体内损伤程度加重。
OBJECTIVE To explore the risk factors for puerperal infection in elderly parturients and the changes of serum interleukin-6(IL-6),procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)levels.METHODS The data of 584 elderly parturients admitted to the Second Affiliated Hospital of Hainan Medical College from Jan 2010 to Jan 2020 were recruited for retrospective analysis.According to whether there were puerperal infections,they were divided into the control group with 552 cases(no puerperal infections)and the case group with 32 cases(puerperal infections).The pathogenic bacteria in the parturients of the case group was analyzed.The levels of serum inflammatory factors were compared between the two groups to summarize the influencing factors for puerperal infection in senile parturients.RESULTS Puerperal infections occurred in 32 patients and the infection rate was 5.48%(32/584),mainly perineal infections.Forty-one pathogenic bacteria were co-cultured and isolated,of which 27 strains were gram-negative bacteria,accounting for 65.85%,and 13 strains were gram-positive bacteria accounting for 31.71%,1 strain was fungus accounting for 2.44%,mainly Escherichia coli.The serum levels of IL-6,PCT and TNF-αin the case group were significantly higher than those in the control group(P<0.05).The proportion of parturients in the case group with forceps/fetal head suction,birth canal injury,and gestational diabetes mellitus was significantly higher than that in the control group(P<0.05).Forceps/fetal head aspiration,birth canal injury,and gestational diabetes are all influencing factors for puerperal infection in older women(P<0.05).CONCLUSION The main pathogenic bacteria of puerperal infection in elderly women are E.coli.After the puerperal infection,the concentration of various serological inflammatory factors in the puerperium increases significantly,which induces aggravation of the body injury.
作者
黄素静
徐秋霞
韦秋圆
许琳
关红琼
HUANG Su-jing;XU Qiu-xia;WEI Qiu-yuan;XU Lin;GUAN Hong-qiong(The Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第24期3803-3806,共4页
Chinese Journal of Nosocomiology
基金
海南省卫生健康行业科研基金资助项目(20A200457)
关键词
高龄产妇
产褥期感染
病原菌
炎性反应
恶露异常
Older parturients
Puerperal infection
Pathogens
Inflammatory reaction
Abnormal lochia
作者简介
通讯作者:关红琼,E-mail:guanhq1962@163.com;黄素静(1980-),女,本科,副主任医师,研究方向:妇产科疾病
