胎膜早破, 破膜时间 , 分娩结局 , 剖宫产率," /> 胎膜早破, 破膜时间 , 分娩结局 , 剖宫产率,"/> Premature rupture of membrane ,  ,Latent period ,  ,Birth outcomes , Cesarean section rate,"/> <span style="line-height:2;font-size:14px;">足月胎膜早破破膜时间长短对</span><span style="line-height:2;font-size:14px;">围产结局的影响</span>
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发育医学电子杂志  2018, Vol. 6 Issue (2): 82-85    
  围产医学   论著 |新生儿 |
足月胎膜早破破膜时间长短对围产结局的影响
杨雪梅 尚丽新
杨雪梅 尚丽新(陆军总医院 妇产科,北京 100700)
Influence of different latent period on perinatal outcomes in term premature rupture of membrane
YANG Xue-mei, SHANG Li-xin
YANG Xue-mei, SHANG Li-xin (Department of Gynaecology & Obstetrics, PLA Army General Hospital Beijing 100700, China)
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摘要  目的  探讨足月胎膜早破(premature rupture of membrane,PROM)孕妇破膜时间长短对分娩结局的影响。 方法 2013 年 1 月至 2016 年 3 月,在陆军总医院妇产科住院分娩的孕妇中,将 912 例足月 PROM 孕妇作为研究对象。根据胎膜破裂至产程发动的时间间隔,分为≥ 24 小时组(57 例)与﹤24 小时组(855 例);≥ 12 小时组(233 例)与﹤ 12 小时组(679 例)。比较不同破膜时间组的基本情况、剖宫产率以及围产结局。采用 χ2 检验和 t 检验进行统计分析。 结果 胎膜破裂至产程发动的时间间隔≥ 24 小时组与﹤ 24 小时组比较,≥ 12 小时组与﹤ 12 小时组比较,孕妇年龄、产次、流产次数、分娩孕周、羊水指数等指标的差异均无统计学差异(P 值均﹥ 0.05)。胎膜破裂至产程发动的时间间隔≥ 24 小时组与﹤ 24 小时组的剖宫产率分别为 66.7%(38/57)与 44.7%(382/855),产褥感染率分别为 8.8%(5/57)与 2.8%(24/855),产后出血率分别为 19.3%(11/57)与 8.8%(75/855),≥ 24 小时组均高于﹤ 24 小时组,差异有统计学意义(χ2 值分别为 10.399、4.390 和 6.933,P 值均﹤ 0.05);但两组间胎儿窘迫、新生儿肺炎的发生率差异无统计学意义(P 值均﹥ 0.05)。胎膜破裂至产程发动的时间间隔≥ 12 小时组的剖宫产率高于﹤ 12 小时组[58.4%(136/233)与 41.8%(284/679),χ2=19.109,P=0.000],但两组间的产褥感染、产后出血、胎儿窘迫、新生儿肺炎的发生率比较,差异均无统计学意义(P 值均﹥ 0.05)。 结论 足月 PROM 破膜时间超过 12 小时,剖宫产分娩的风险将明显增加,破膜时间超过 24 小时,剖宫产分娩、产褥感染及产后出血发生率均显著增高。
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关键词:  font-size:14px  胎膜早破')" href="#">">胎膜早破  font-size:14px  破膜时间 ')" href="#">">破膜时间   font-size:14px  分娩结局 ')" href="#">">分娩结局   font-size:14px  剖宫产率')" href="#">">剖宫产率    
Abstract: Objective   To investigate the in?uence of different latent period on perinatal outcomes in term prematur rupture of membrane (PROM).  Methods From January 2013 to March 2016, 912 cases of pregnancy women with term PROM hospitalized in Department of Gynecology & Obstetrics, PLA Army General Hospital, were included. According to the time interval from PROM to labor, they were divided into latent period ≥ 24 h group (57 cases) and ﹤ 24 h group (855 cases), latent period ≥ 12 h group (233 cases) and ﹤12 h group (679 cases). The basic situation, cesarean section rate and perinatal outcomes of these groups were compared. Chi-square and t test were used for statistical analysis. Results There was no signi?cant difference on the age of pregnant women, delivery times, abortion times, gestational age at delivery and amniotic ?uid index between latent period ≥ 24 h group and ﹤ 24 h group, between latent period ≥ 12 h group and ﹤ 12 h group (all P ﹥ 0.05). The cesarean section rate of latent period ≥ 24 h group and ﹤24 h group was respectively 66.7%(38/57) and 44.7 (382/855), the proportion of puerperal infection wasrespectively 8.8% (5/57) and 2.8 (24/855), and the proportion of postpartum hemorrhage was respectively 19.3% (11/57) and 8.8 (75/855). The above indicators of latent period ≥ 24 h group were higher than that of ﹤ 24 h with statistical signi?cance (χ2=10.399, 4.390 and 6.933, respectively, all P ﹤ 0.05); but the incidence of fetal distress and neonatal pneumonia of two groups were no statistical difference (both P ﹥0.05). The cesarean section rate of latent period ≥ 12 h group was higher than that of ﹤ 12 h group[(58.4%, 136/233) vs (41.8%, 284/679)], and there was significant difference (χ2=19.109,P=0.000). But the incidence of puerperal infection, postpartum hemorrhage, fetal distress, and neonatal pneumonia between two groups were no statistical difference (all P ﹥ 0.05). Conclusions For the term PROM, the risk of cesarean delivery significantly increases when latent period ≥ 12 h, and the risk of cesarean delivery, puerperal infection and postpartum hemorrhage signi?cantly increases when latent period ≥ 24 h.
Key words:  font-size:14px    Premature rupture of membrane ')" href="#">">Premature rupture of membrane    font-size:14px     ')" href="#">">     Latent period    font-size:14px     ')" href="#">">     Birth outcomes    font-size:14px    Cesarean section rate')" href="#">">Cesarean section rate
收稿日期:  2016-12-19                出版日期:  2018-04-30      发布日期:  2018-05-22      期的出版日期:  2018-04-30
基金资助: 卫生部医药卫生科技发展研究中心项目(W2013GJ01)
通讯作者:  尚丽新https://ysk.familydoctor.com.cn/3307/    E-mail:  19932003@163.com
引用本文:    
杨雪梅 尚丽新. 足月胎膜早破破膜时间长短对围产结局的影响[J]. 发育医学电子杂志, 2018, 6(2): 82-85.
YANG Xue-mei, SHANG Li-xin. Influence of different latent period on perinatal outcomes in term premature rupture of membrane. Journal of Developmental Medicine(Electronic Version), 2018, 6(2): 82-85.
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