摘要
目的探讨妊娠合并脓毒症的临床特点、诊断和治疗方法以及妊娠结局。方法回顾性分析2017年1月至2019年12月在武汉大学人民医院产科住院的23例妊娠合并脓毒症患者的临床资料,了解导致妊娠合并脓毒症的临床特点、高危因素、病原体分布、治疗方案及妊娠结局。结果(1)23例患者平均年龄29.5岁,初产妇12例,经产妇11例,妊娠期发病20例,产褥期发病3例;(2)感染来源主要为生殖道感染,最常用的抗生素是碳青霉烯类泰能(17例,73.9%);(3)23例孕产妇均治愈出院,患者平均住院日9.5 d;(4)围产儿中活产21例,其中足月产13例,早产8例,死胎引产2例。结论妊娠合并脓毒症多发生于妊娠期,以生殖道感染最常见,最常见的病原体为大肠埃希菌。因该病特点为起病急,病情发展迅速,早期识别高风险人群,并尽早给予患者高级别抗生素抗感染可有效改善妊娠结局。
Objective To explore the clinical characteristics,diagnosis and treatment options of pregnancy-associated sepsis.Methods We retrospectively analyzed the clinical data of 23 patients with pregnancy-associated sepsis hospitalized in the Obstetrics department of Renmin Hospital of Wuhan University from January 2017 to December 2019,and analyzed the high-risk factors leading to sepsis in pregnant women,the distribution of pathogens of pregnancy-associated sepsis,treatment options and pregnancy outcomes.Results(1)The average age of the patients was 29.5 years.12 cases were primiparous,and 11 cases were multiparous women.Sepsis occurred during pregnancy in 20 cases and puerperal period in three cases.(2)The main source of the infection in the 23 patients was genital tract.The most commonly used antibiotics were carbapenems(17 cases,73.9%).(3)All of the 23 patients were cured and discharged.The average hospital stay was 9.5 days.(4)There were 21 live births and two stillbirth among the perinatal infants.The live births included 13 full-term births,and 8 preterm births.Conclusions Pregnancy-associated sepsis often occurred during pregnancy and reproductive tract infection was the main source of the infection,with Escherichia coli being the most common causative agent.Pregnancy associated sepsis is characterized by rapid onset and progression.Early identification of high-risk individuals and early administration of high-level antibiotics to combat the infection were critical to improve the pregnancy outcomes.
作者
彭良玉
陈建华
杨菁
Peng Liangyu;Chen Jianhua;Yang Jing(Obstetrics Department,Reproductive Medicine Center,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《中华产科急救电子杂志》
2021年第3期165-168,共4页
Chinese Journal of Obstetric Emergency（Electronic Edition）
关键词
脓毒症
妊娠
产后期
产褥期感染
Sepsis
Pregnancy
Postpartum period
Puerperal infection
