【摘要】：目的探討疤痕子宮患者再次剖宮產(chǎn)術(shù)后產(chǎn)褥感染的危險(xiǎn)因素、病原學(xué)和耐藥性,為臨床治療提供參考依據(jù)。方法自2015年1月-2016年6月前瞻性收集醫(yī)院收治的疤痕子宮再次行剖宮產(chǎn)術(shù)的孕產(chǎn)婦382例,分析疤痕子宮患者再次剖宮產(chǎn)術(shù)后產(chǎn)褥感染的發(fā)生率、危險(xiǎn)因素、病原學(xué)和耐藥性。結(jié)果 382例孕產(chǎn)婦,共31例發(fā)生產(chǎn)褥感染,感染率為8.12%;多因素回歸分析顯示,兇險(xiǎn)型前置胎盤、兇險(xiǎn)型前置胎盤合并胎盤植入、產(chǎn)后出血和孕產(chǎn)婦陰道炎是疤痕子宮患者再次剖宮產(chǎn)術(shù)后產(chǎn)褥感染的獨(dú)立危險(xiǎn)因素(P0.05);共培養(yǎng)出26株病原菌,以革蘭陰性菌為主,占65.38%,革蘭陰性菌耐藥率最高的是頭孢他啶,為41.18%。結(jié)論疤痕子宮患者再次剖宮產(chǎn)術(shù)后產(chǎn)褥感染率較高,兇險(xiǎn)型前置胎盤、兇險(xiǎn)型前置胎盤合并胎盤植入、產(chǎn)后出血和孕產(chǎn)婦陰道炎是高危因素,革蘭陰性菌較為常見,對(duì)青霉素和頭孢他啶耐藥率較高。
[Abstract]:Objective to investigate the risk factors, etiology and drug resistance of puerperal infection after cesarean section in patients with scar uterus. Methods from January 2015 to June 2016, 382 pregnant women with scar uterus undergoing cesarean section were collected prospectively. The incidence, risk factors, etiology and drug resistance of puerperal infection after cesarean section in patients with scar uterus were analyzed. Results among 382 pregnant and parturient women, 31 cases had puerperal infection and the infection rate was 8.12%. Multivariate regression analysis showed that severe placenta previa with placenta accreta postpartum hemorrhage and maternal vaginitis were independent risk factors of puerperal infection after cesarean section in patients with scar uterus (P0.05). A total of 26 strains of pathogenic bacteria were cultured, mainly Gram-negative bacteria (65.38). The highest resistance rate of Gram-negative bacteria was ceftazidime (41.18). Conclusion the puerperal infection rate of the patients with scar uterus after cesarean section is high, the dangerous placenta previa with placenta accreta, postpartum hemorrhage and vaginitis of pregnant women are high risk factors, Gram-negative bacteria are more common. The resistance to penicillin and ceftazidime was higher.
【作者單位】： 縉云縣婦幼保健院保健科;縉云縣人民醫(yī)院婦產(chǎn)科;縉云縣婦幼保健院圍產(chǎn)保健科;
【基金】：浙江省醫(yī)藥衛(wèi)生一般研究計(jì)劃基金(2014KYB241)
【分類號(hào)】：R714.6

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