胎膜早破和胎膜完整羊膜腔内细菌状况的对照研究

目的探讨妊娠晚期胎膜早破和胎膜完整孕妇羊膜腔内细菌感染状况。方法随机选择胎膜早破-剖宫产和胎膜完整-剖宫产病例,于剖宫产时取羊水10ml做细菌培养,比较二组羊水细菌发生率和细菌种类,并讨论胎膜早破破膜时间与羊水细菌感染的关系。结果30例胎膜早破组羊水有细菌20例（66.7%）,21例胎膜完整组有细菌2例（9.5%）,二组差异有统计学意义（P〈0.001）。胎膜早破羊水细菌最多是葡萄球菌,其次是链球菌、肠杆菌,2例胎膜完整羊水细菌均为表皮葡萄球菌。在胎膜早破中,有无羊水细菌的破膜时间差异无统计学意义。结论胎膜早破大大多于胎膜完整的羊膜腔内细菌感染,胎膜早破的发生较破膜时间对感染的意义可能更重要,应于胎膜早破早期使用主要针对葡萄球菌、链球菌或兼顾大肠杆菌的抗生素。

COMPARATIVE STUDY ON BACTERIUM CONDITION IN AMNIOTIC CAVITY OF PREMATURE RUPTURE OF MEMBRANE WITH INTACT FETAL MEMBRANE

Objective To study bacterial condition in amniotic cavity of premature rupture of membrane and intact fetal membrane in third trimester. Methods We cultured bacterium in 10 ml aqua amnii from abdominal delivery patients with premature rupture of membrane and intact fetal membrane, the incidence and types of bacterial infect between the two groups were compared, and the relationship between rupture time and bacterial infect in cases of premature rupture of membrane was discussed. Results There were 20 cases with bacterial aqua amnii from 30 cases with premature rupture of membrane （66.7%）, while only 2 eases with bacterial aqua amnii in 21 cases with intact fetal membrane （9. 5%）, the difference was significant, P〈0.001. Staphylococcus was common in cases with preterm rupture, streptococcus and colon bacillus were secondary. There were both epidermis staphylococcus in 2 cases with intact fetal membrane. The mean time of rupture between aqua amnii infection and none was not significant. Conclusion There are more bacterial infection in amniotic cavity in cases with preterm rupture of membrane than whom with intact fetal membrane. Thus, antibiotic has to be used in early stage of preterm rupture of membrane.