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目的探讨胎膜早破亚临床绒毛膜羊膜炎与早发型新生儿败血症的关系。方法采用回顾性分析方法,对杭州市第一人民医院2009—2012年收治的2 700例单胎胎膜早破孕妇的临床资料进行分析。结果 2 700例胎膜早破患者中,发生亚临床绒毛膜羊膜炎占38.56%;发生临床绒毛膜羊膜炎占10.00%。亚临床绒毛膜羊膜炎组与无绒毛膜羊膜炎组比较,破膜距胎儿分娩时间明显延长(P<0.01),早发型新生儿败血症发生率明显增高(P<0.01)。新生儿早发型败血症血培养病原菌中革兰阳性菌与革兰阴性菌分别占56.45%和37.10%。最多见的病原菌为大肠埃希菌,占30.65%;其次为无乳链球菌,占25.81%;真菌检出率为6.45%,且均为早产儿。结论胎膜早破亚临床绒毛膜羊膜炎与早发型新生儿败血症密切相关。大肠埃希菌及无乳链球菌是主要致病菌。
Objective To investigate the relationship between subcapsular premature rupture of subclinical chorioamnionitis and early-onset neonatal sepsis. Methods A retrospective analysis was performed to analyze the clinical data of 2 700 pregnant women with singletonic premature rupture of membranes in First People’s Hospital of Hangzhou from 2009 to 2012. Results Among 2 700 cases of premature rupture of membranes, subclinical chorioamnionitis accounted for 38.56%; clinical chorioamnionitis accounted for 10.00%. Compared with non-chorioamnionitis group, the childbirth time was significantly longer in subclinical chorioamnionitis group (P <0.01), and the incidence of early onset neonatal sepsis was significantly higher (P <0.01). Gram-positive bacteria and Gram-negative bacteria accounted for 56.45% and 37.10% respectively in the blood culture pathogens of neonatal early-onset sepsis. The most common pathogens were Escherichia coli, accounting for 30.65%; followed by Streptococcus agalactiae, accounting for 25.81%; fungal detection rate was 6.45%, and are premature children. Conclusion Premature rupture of membranes subclinical chorioamnionitis is closely related to early-onset neonatal sepsis. Escherichia coli and Streptococcus agalactiae are the main pathogens.