本文關(guān)鍵詞： 自發(fā)性早產(chǎn) 保胎時間 分娩方式 早產(chǎn)兒預(yù)后　出處：《吉林大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：研究不同病因?qū)е碌淖园l(fā)性早產(chǎn)的發(fā)病及終止妊娠孕周、保胎時間、早產(chǎn)兒預(yù)后及不同分娩方式對早產(chǎn)兒預(yù)后的影響。 方法：回顧性分析2009年至2012年于我院分娩的117例自發(fā)性早產(chǎn)，比較分析不同孕周、不同原因、不同保胎時間及分娩方式對新生兒結(jié)局的影響。 結(jié)果：①導(dǎo)致自發(fā)性早產(chǎn)病因最主要為宮內(nèi)感染，約占研究總數(shù)的34.19%；其次為瘢痕子宮、雙胎妊娠，均占總數(shù)的17.95%；隨后依次為胎位異常（主要指臀位），，占總數(shù)的11.11%，羊水過多者占總數(shù)的9.40%，生殖道異常者占總數(shù)的8.55%等。其中32周前臀位所占比例較大，約占24.24%；32周后則比例降低，約占5.95%。而宮內(nèi)感染、瘢痕子宮及雙胎妊娠則無孕周差異性，孕32周前后均為誘發(fā)早產(chǎn)的主要原因。 ②對比其它引起早產(chǎn)的病因及危險因素，宮內(nèi)感染者保胎時間最短，且存在宮內(nèi)感染者即使抗感染治療，早產(chǎn)亦常不可避免。 ③32周前剖宮產(chǎn)分娩可明顯降低新生兒窒息及顱內(nèi)出血的發(fā)生率（P＜0.05）；32周后剖宮產(chǎn)明顯降低顱內(nèi)出血發(fā)生率（P＜0.05），但在新生兒窒息方面剖宮產(chǎn)與順產(chǎn)無明顯差異（P＞0.05）。 ④未足月胎膜早破早產(chǎn)較自發(fā)性早產(chǎn)者新生兒感染率明顯增高（P＜0.05）。 結(jié)論：①宮內(nèi)感染是自發(fā)性早產(chǎn)的最主要病因，因?qū)m內(nèi)感染引發(fā)先兆早產(chǎn)的保胎時間最短。②在充分考慮早產(chǎn)兒存活可能性的基礎(chǔ)上，剖宮產(chǎn)能顯著降低新生兒窒息及顱內(nèi)出血發(fā)生率。③發(fā)生胎膜早破者較未發(fā)生胎膜早破者新生兒感染率明顯增高。④產(chǎn)前積極防治感染，能有效減少早產(chǎn)發(fā)生，降低圍生兒死亡率及患病率。
[Abstract]:Objective: to study the influence of spontaneous preterm delivery (SPC) on the prognosis of preterm infants by different etiological factors, including gestational weeks, pregnancy retention time, prognosis of preterm infants and different delivery methods. Methods: 117 cases of spontaneous preterm delivery in our hospital from 2009 to 2012 were analyzed retrospectively. Results the most common cause of spontaneous preterm labor was intrauterine infection, which accounted for 34.19% of the total number of studies, followed by scar uterus and twin pregnancy. The number of abnormal fetal position (mainly gluteal position, 11.11% of the total), amniotic fluid (9.40%), genital tract abnormality (8.55%%), and the ratio of breech position before 32 weeks was larger, and the proportion of 24.2424% decreased after 32 weeks, respectively, in the following order: 17.95% of the total number, 11.11% of the total number, 9.40% of the total number of amniotic fluid and 8.55% of the total number of patients with abnormal reproductive tract. However, intrauterine infection, scar uterus and twin pregnancy had no difference in gestational weeks, and 32 weeks after pregnancy were the main causes of preterm delivery. Compared with other causes and risk factors of premature delivery, intrauterine infection has the shortest time to protect the fetus, and even if the intrauterine infection is treated with anti-infection, premature delivery is often inevitable. The incidence of asphyxia and intracranial hemorrhage was significantly decreased by cesarean section after 332 weeks (P < 0.05) and the incidence of intracranial hemorrhage was significantly decreased after caesarean section (P < 0.05), but there was no significant difference between caesarean section and spontaneous delivery in asphyxia neonatorum (P > 0.05). (4) the infection rate of newborns with premature premature rupture of unmatured membranes was significantly higher than that of spontaneous premature delivery (P < 0.05). Conclusion Intrauterine infection is the main cause of spontaneous preterm delivery. The shortest duration of fetal preservation for threatened preterm delivery due to intrauterine infection is based on the full consideration of the possibility of survival of preterm infants. Cesarean section could significantly reduce the incidence of asphyxia and intracranial hemorrhage in newborns. 3. The infection rate of newborns with premature rupture of membranes was significantly higher than that of those without premature rupture of membranes. Reduce perinatal mortality and morbidity.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.7

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