摘要
目的分析妊娠合并重症社区获得性肺炎孕妇的临床特征及对预后的影响,并探讨相关的危险因素。方法2012年9月至2017年9月于广东省"珠三角"地区7家三级医院住院的孕妇共324398例,其中临床诊断为妊娠合并重症社区获得性肺炎(重症肺炎组)的孕妇33例(0.010%,33/324398),选取同期临床诊断的普通社区获得性肺炎孕妇214例(0.066%,214/324398)为对照组,比较两组孕妇的一般情况、临床特征、母儿结局等,对相关危险因素进行多因素logistic回归分析。结果(1)两组孕妇的一般情况:重症肺炎组与对照组孕妇的诊断孕周[分别为(28±8)、(23±8)周]、诊断时的体质指数[分别为(21.7±2.1)、(25.5±3.4)kg/m2]、低收入者的比例[分别为54.5%(18/33)、31.8%(68/214)],分别比较,差异均有统计学意义(P均<0.05);而两组孕妇的年龄、孕次、产次、教育程度、发病季节,妊娠合并糖尿病者、妊娠合并高血压者、哮喘者的比例,分别比较,差异均无统计学意义(P均>0.05)。(2)两组孕妇的临床表现及辅助检查结果:重症肺炎组孕妇发热、气促的发生率[分别为100.0%(33/33)、90.9%(30/33)]均高于对照组[分别为75.2%(161/214)、16.8%(36/214)],两组分别比较,差异均有统计学意义(P均<0.05)。重症肺炎组与对照组孕妇的中位外周血白细胞计数[分别为12.3×109/L、10.2×109/L]、血红蛋白水平[分别为(84±18)、(107±14)g/L]、白蛋白水平[分别为(26±4)、(37±3)g/L],肾功能[中位尿素氮分别为3.7mmol/L、2.4mmol/L,肌酐水平分别为(72±25)、(45±11)μmol/L],分别比较,差异均有统计学意义(P均<0.05)。而两组孕妇的凝血功能、心功能分别比较,差异均无统计学意义(P均>0.05)。(3)治疗:重症肺炎组孕妇中,12例(36.4%,12/33)行有创机械通气,9例(27.3%,9/33)行无创机械通气,机械通气的时间为(7±4)d;8例(24.2%,8/33)出现感染性休克使用血管活性药物维持血压;对照组孕妇无上述表现者(P<0.05)�
Objective To analyze clinical characteristics of severe community-acquired pneumonia during pregnancy and its outcomes, and to explore the relevant risk factors. Methods From September 2012 to September 2017, 324 398 pregnancies admitted in 7 tertiary hospitals were included. Clinical data of 33 cases of pregnancies with severe community-acquired pneumonia (severe pneumonia group) and 214 cases of pregnancies with common community-acquired pneumonia (control group) were reviewed retrospectively, including the clinical information, manifestations, laboratory examinations and pregnancy outcomes. Relevant risk factors were analyzed by multivariate logistic regression analysis. Results (1) General data: pregnancies with severe community-acquired pneumonia accounted for 0.010% (33/324 398) of hospitalized pregnancies, the gestational age of two groups were (28±8) and (23±8) weeks, body mass index were (21.7±2.1) and (25.5±3.4) kg/m2, rate of low income were 54.5% (18/33) and 31.8% (68/214) , respectively. The differences between two groups were all statistically significant (all P<0.05). No significant differences were found in age, pregnancy and parity times, rate of main pregnant complications such as diabetes and hypertension, educational level, asthma and onset seasons between two groups (all P>0.05). (2) Clinical data: the severe pneumonia group had significantly higher incidence of fever [100.0% (33/33) vs 75.2% (161/214) ], shortness of breath (90.9% vs 16.8%) compared with the control group (all P<0.05) .The median peripheral leukocytes counts were 12.3×109/L and 10.2×109/L, the hemoglobin level were (84±18) and (107±14) g/L,the albumin level were (26±4) and (37±3) g/L, the median serum urea nitrogen level were 3.7 and 2.4 mmol/L, the serum creatinine level were (72±25) and (45±11) μmol/L, respectively in two groups. The differences were all statistically significant (all P<0.05). No significantly statistical differences were found in coagulation indicator and cardiac function between two groups (
作者
贺艳军
麦彩园
陈陆静
张晓曼
周建勇
蔡绵
陈永星
祁青莲
杨在东
He Yanjun;Mai Caiyuan;Chen Luting;Zhang Xiaoman;Zhou Jianyong;Cai Mian;Chen Yongxing;Qi Qinglian;Yang Zaidong(Department of Intensive Care Unit,Foshan Woman and Children Hospital,Southern Medical University,Foshan 528000,China)
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2018年第12期842-848,共7页
Chinese Journal of Obstetrics and Gynecology
基金
广东省佛山市卫生和计划生育局医学科研立项课题(20180109).
关键词
妊娠并发症
感染性
肺炎
危险因素
妊娠结局
Pregnancy complications,infectious
Pneumonia
Risk factors
Pregnancy outcome
