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目的探讨先兆早产患者应用抗生素的必要性,为临床治疗先兆早产提供理论基础。方法选择2012年5月至2013年2月在深圳市龙华新区人民医院就诊的150例单胎妊娠先兆早产病例,所有病例按随机数字表法分为3组:利托君组、抗生素组、联合利托君及抗生素组,每组各50例,分别给予干预措施后,监测入选病例血常规、记录延长妊娠的时间、检测相关炎症因子水平、宫颈细菌培养。结果患者阴道内分泌物进行细菌培养后,确认存在致病菌者81例,培养致病菌菌株96株。其中大肠杆菌24株,金黄色葡萄球菌21株,表皮葡萄球菌16株,阴沟肠杆菌14株,屎肠球菌15株,其他细菌6株。阴道寄生菌群对万古霉素、亚胺培南和阿米卡星等药物耐药性较差,在改善炎性介质肿瘤坏死因子-α、白细胞介素-10和金属蛋白酶-3方面,联合治疗组具有明显优势。单独使用利托君、抗生素均可有效增加孕龄、婴儿出生体重和Apgar评分,联合治疗组治疗效果更为明显。结论抗生素可有效延长妊娠时间,故先兆早产患者有必要运用抗生素以提高母婴生存质量。
Objective To investigate the necessity of antibiotics in threatened preterm labor and to provide a theoretical basis for clinical treatment of threatened preterm labor. Methods A total of 150 premature birth cases of singleton pregnancies with singleton pregnancy were selected from May 2012 to February 2013 in Longhua New District People’s Hospital of Shenzhen. All cases were divided into 3 groups according to random number table: Rituxan group, antibiotics group, union Rituximab and antibiotics group, each group of 50 cases, respectively, after giving interventions, monitoring selected cases of blood routine, record the extension of pregnancy time, test the level of inflammatory cytokines, cervical bacterial culture. Results In patients with vaginal secretions bacterial culture, confirm the presence of pathogens in 81 cases, 96 strains of pathogenic bacteria culture. Among them, 24 were Escherichia coli, 21 Staphylococcus aureus, 16 Staphylococcus epidermidis, 14 Enterobacter cloacae, 15 Enterococcus faecium and 6 other bacteria. Vaginal parasitic flora on vancomycin, imipenem and amikacin and other drugs less well, in improving the inflammatory mediators of tumor necrosis factor-α, interleukin-10 and metalloproteinase-3, the joint The treatment group has obvious advantages. With Rituxan alone, antibiotics can effectively increase gestational age, birth weight and Apgar score, and the combination therapy group is more effective. Conclusion Antibiotics can prolong the pregnancy time effectively. Therefore, it is necessary for the patients with threatened preterm birth to use antibiotics to improve their quality of life.