220例未足月胎膜早破回顾性研究

目的回顾性研究我院220例未足月胎膜早破患者胎膜早破（PPROM）的相关因素、分娩结局及对母儿的影响以指导临床。方法将120例符合病例纳入标准的未足月胎膜早破患者按孕周分为两组,28周～34＋6组及35周～36＋6周组。统计胎膜早破相关因素,统计对比不同孕周分娩方式、不同孕周产妇情况、不同孕周新生儿围生期情况。结果胎膜早破的原因很多,生殖道感染是引起PPROM的主要原因;28周～34＋6周组85例,自然分娩60例、臀位助产14例、剖宫产11例;而35周～36＋6周组135例,自然分娩72例、臀位助产7例、剖宫产56例,两组存在较大差异（p〈0.05）;35周～36＋6周PPROM患者的宫内感染、产后出血、新生儿肺炎、新生儿颅内出血、新生儿呼吸窘迫综合征（RDS）及围生儿死亡情况明显低于28周～34＋6周PPROM患者（p〈0.05）,产褥感染无明显差异（p〉0.05）。结论临床上应尽量预防PPROM,对于已发生PPROM的患者,选择何种分娩方式对母婴有利,应结合临床实际综合考虑。

Retrospective Study on 220 Cases of Preterm Premature Rupture of the Membrane

Objective To retrospective study on 220 cases of preterm premature rupture of the membrane （PPROM） in my hospital, including its relative factors, result of parturition and influence to mother and child.Methods All 120 cases were divided into two groups, 28-34^＋6 weeks group and 35-36^＋6 weeks group.Some targets, such as relative factors of PPROM, parturition patterns, parturient conditions, neonate conditions in different gestational weeks.Results There were a lot of reasons caused of PPROM, the most important one was genital duct; gential tract; 85 cases in 28-34^＋6 weeks group, among 60 cases in spontaneous delivery, 14 cases in assisted breech delivery, 11 cases of uterine-incision delivery; 135 cases in 35-36^＋6 weeks group, among 72 cases in spontaneous delivery, 7 cases in assisted breech delivery, 56 cases of uterine-incision delivery.The difference had statistical significance between two groups （p〈0.05）.The complicated syndrome in 35-36^＋6 weeks PPROM were lower than that of 28-34^＋6 weeks group （p〈0.05）, there wasn＇t distinct difference of puerperal infection between two groups （p〉0.05）.Conclusion The PPROM should be prevented at first, when PPROM was happened, we need consider method together with clinical practice to select what deliver patterns is benefit for mother and child.