妊娠<28周PPROM期待治疗的影响因素及临床意义(1)
【摘要】 目的：探讨妊娠<28周的未足月胎膜早破(PPROM)患者期待治疗的影响因素及临床意义。方法：选取2014年1月-2015年12月笔者所在医院39例24～27+6周PPROM患者。按期待治療后分娩孕周分为：A组(<32周)、B组(≥32周)，比较两组母儿结局。采用Cox回归对影响期待治疗时间的因素分析。结果：(1)两组入院羊水指数、宫颈管长度、宫口扩张、期待治疗时间方面比较差异有统计学意义(P<0.05)。(2)随期待时间延长，新生儿体重增加、入住NICU时间缩短，新生儿并发症逐渐降低，差异有统计学意义(P<0.05)。(3)Cox回归分析显示：破膜孕周、宫颈管长度及入院羊水指数是影响期待治疗时间的主要因素[HR分别为7.33，0.97，0.86；95%CI分别为(2.31，23.51)，(0.93，0.99)，(0.81，0.90)]。结论：破膜孕周、宫颈管长度及入院羊水指数是影响妊娠<28周PPROM患者期待时间的主要因素。
【关键词】 未足月胎膜早破； 期待治疗； 影响因素
doi：10.14033/j.cnki.cfmr.2017.16.003 文献标识码 A 文章编号 1674-6805(2017)16-0005-03
Influential Factors and Clinical Significance of PPROM Expectation for Treatment in Less than 28 Weeks of Gestation/FANG Zhuan-ji，LIN Yuan，YU Ai-li.//Chinese and Foreign Medical Research，2017，15(16)：5-7
【Abstract】 Objective：To explore the influential factors and clinical significance of PPROM expectation for treatment in less than 28 weeks of gestation.Method：39 patients with PPROM 24-27+6 weeks in the author，s hospital from January 2014 to December 2015 were selected.According to the expected treatment time，the patients were divided into A group(<32 weeks) and B group(≥32 weeks)，the maternal outcome of two groups were compared.Cox regression was used to analyze the factors influencing the expected treatment time.Result：(1)There were significant differences between the two groups in the admission of amniotic fluid index，length of cervical canal，cervix dilatation and expectation of treatment time(P<0.05).(2)With the prolonged expectation，the weight gain of neonates increased，the median time to stay NICU was shorter，neonatal complications gradually decreased，there were significant differences (P<0.05).(3)Cox regression analysis showed that rupture of membranes，length of cervical canal and admission amniotic fluid index were the main factors influencing the expected treatment time[HR were 7.33，0.97，0.86；95%CI were (2.31，23.51)，(0.93，0.99)，(0.81，0.90)].Conclusion：Rupture of membranes，length of cervical canal and admission amniotic fluid index are the main factor affecting the expectation time of PPROM in less than 28 weeks of gestation.
【Key words】 Premature rupture of membranes； Expect treatment； Influencing factors.
First-author’s address：Maternity and Children’s Hospital of Fuzhou Province，Fuzhou 350001，China
未足月胎膜早破(preterm premature rupture of membranes，PPROM)的管理是产科临床中棘手的问题。一方面期待治疗增加母儿感染发病率；另一方面积极干预同样增加新生儿并发症及死亡率。对于24～27+6周的PPROM患者，由于孕周较小，期待治疗时间长，发生母儿感染等并发症风险大，故多主张不宜继续妊娠[1]。但临床上许多不足28周的PPROM患者，患方强烈要求保胎。故本研究评估24～27+6周PPROM患者经期待治疗后母儿结局，探讨影响期待治疗的因素，以便更好地指导临床实践。, 百拇医药(方专集 林元 余爱丽)
【关键词】 未足月胎膜早破； 期待治疗； 影响因素
doi：10.14033/j.cnki.cfmr.2017.16.003 文献标识码 A 文章编号 1674-6805(2017)16-0005-03
Influential Factors and Clinical Significance of PPROM Expectation for Treatment in Less than 28 Weeks of Gestation/FANG Zhuan-ji，LIN Yuan，YU Ai-li.//Chinese and Foreign Medical Research，2017，15(16)：5-7
【Abstract】 Objective：To explore the influential factors and clinical significance of PPROM expectation for treatment in less than 28 weeks of gestation.Method：39 patients with PPROM 24-27+6 weeks in the author，s hospital from January 2014 to December 2015 were selected.According to the expected treatment time，the patients were divided into A group(<32 weeks) and B group(≥32 weeks)，the maternal outcome of two groups were compared.Cox regression was used to analyze the factors influencing the expected treatment time.Result：(1)There were significant differences between the two groups in the admission of amniotic fluid index，length of cervical canal，cervix dilatation and expectation of treatment time(P<0.05).(2)With the prolonged expectation，the weight gain of neonates increased，the median time to stay NICU was shorter，neonatal complications gradually decreased，there were significant differences (P<0.05).(3)Cox regression analysis showed that rupture of membranes，length of cervical canal and admission amniotic fluid index were the main factors influencing the expected treatment time[HR were 7.33，0.97，0.86；95%CI were (2.31，23.51)，(0.93，0.99)，(0.81，0.90)].Conclusion：Rupture of membranes，length of cervical canal and admission amniotic fluid index are the main factor affecting the expectation time of PPROM in less than 28 weeks of gestation.
【Key words】 Premature rupture of membranes； Expect treatment； Influencing factors.
First-author’s address：Maternity and Children’s Hospital of Fuzhou Province，Fuzhou 350001，China
未足月胎膜早破(preterm premature rupture of membranes，PPROM)的管理是产科临床中棘手的问题。一方面期待治疗增加母儿感染发病率；另一方面积极干预同样增加新生儿并发症及死亡率。对于24～27+6周的PPROM患者，由于孕周较小，期待治疗时间长，发生母儿感染等并发症风险大，故多主张不宜继续妊娠[1]。但临床上许多不足28周的PPROM患者，患方强烈要求保胎。故本研究评估24～27+6周PPROM患者经期待治疗后母儿结局，探讨影响期待治疗的因素，以便更好地指导临床实践。, 百拇医药(方专集 林元 余爱丽)