【摘要】 目的:分析产时发热的相关危险因素,提出相应的处理对策。方法:选择我院2015年3-10月共1 629名进入产房待产的住院孕产妇为研究对象,其中出现产时发热(体温≥37.5℃)的患者共58名(发热组),均排除非产科因素导致的发热,其余1 571名孕妇设为对照组。比较两组产妇产前及产后白细胞数、中性粒细胞数、C反应蛋白水平、产程时长、破膜至分娩时长,比较其使用宫颈扩张球囊、硬膜外镇痛、人工破膜、胎膜早破、阴道感染等各种临床特征。结果:发热组与对照组比较,总产程与破膜至分娩时间明显延长(P<0.001);使用硬膜外镇痛、宫颈扩张球囊引产、人工破膜均为产时发热的危险因素(OR>1,P<0.001)。结论:延长的产程与破膜至分娩时间、硬膜外分娩镇痛是产时发热的高风险因素,对这些高感染风险患者,应该尽量减少无指征的人工干预与阴道操作,产时加强对体温、白细胞及中性粒细胞计数、CRP等感染指标的监测。更多还原

【Abstract】 Objective: To analyze the risk factors of intrapartum fever, and put forward the corresponding countermeasures. Methods: Of 1 629 expectant pregnant women admitted in Haizhu Maternal and Children’s Hospital during March to October 2015, 58 cases suffered intrapartum fever without non-obstetric causes induced fever(with temperature ≥ 37.5℃) and were set as fever group, and the other 1 571 cases were set as control group. White blood cell count, neutrophil count, content of C-reactive protein(CRP), labor length and length of membrane rupture to delivery were compared between the two groups, and the correlations were studied of intrapartum fever to the use of cervical dilation balloon, epidural analgesia, artificial rupture of membrane, premature rupture of membranes and vaginal infection. Results: The total delivery time and the length of membrane rupture to labor were significantly longer in fever group than in control group(P<0.001). Using of epidural analgesia, cervical dilation balloon and artificial rupture of membranes were all the risk factors for intrapartum fever(OR>1, P<0.001). Conclusions: Prolonged labor, delayed membrane rupture to delivery and epidural analgesia are the high-risk factors for intrapartum fever. It should be attached great importance to reduce artificial intervention and vaginal operation for patients with no indications, strengthen monitoring on body temperature, leukocyte and neutrophil counts, as well as the infection indexes such as CRP.更多还原