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目的探析妊娠期急性肾盂肾炎的临床表现、致病菌组成及预后转归。方法回顾分析本院2010年1月~2013年6月65例妊娠合并急性肾盂肾炎患者临床资料。结果 65例患者平均年龄25.9岁,90.8%的患者是初产妇。在孕早期发病的占20%,在孕中期发病的占64.1%,在孕晚期发病的占16.9%。致病菌主要是非特殊性细菌,其中60%~80%的致病菌是大肠埃希氏杆菌,其次是葡萄球菌、变形杆菌和粪链球菌,少数是绿脓杆菌。对头孢菌素类抗生素敏感,耐药率低。治愈62例,治愈率95.4%,有3例转为慢性肾盂肾炎,占4.6%。结论妊娠合并急性肾盂肾炎大多在孕中期发生,主要的致病菌是大肠埃希氏杆菌,具备抗菌谱广、抗菌作用强、过敏反应较青霉素类少见、低毒等优点的头孢菌素类抗生素是治疗用药的首选。
Objective To investigate the clinical manifestations, pathogens composition and prognosis of acute pyelonephritis during pregnancy. Methods The clinical data of 65 patients with acute pyelonephritis during pregnancy in our hospital from January 2010 to June 2013 were retrospectively analyzed. Results The average age of 65 patients was 25.9 years old, 90.8% of the patients were primipara. In early pregnancy incidence of 20%, incidence of 64.1% in the second trimester, incidence of 16.9% in the third trimester of pregnancy. Pathogenic bacteria are mainly non-specific bacteria, of which 60% to 80% of pathogens are Escherichia coli, followed by Staphylococcus aureus, Proteus and Streptococcus faecalis, a small number of Pseudomonas aeruginosa. Sensitive to cephalosporins antibiotics, drug resistance rate is low. 62 cases were cured, the cure rate was 95.4%, and 3 cases were converted to chronic pyelonephritis, accounting for 4.6%. Conclusions Pregnancy complicated with acute pyelonephritis mostly occurs in the second trimester of pregnancy. The main pathogen is Escherichia coli, which has the advantages of wide antibacterial spectrum, strong antibacterial effect, rare allergic reaction compared with penicillin, low toxicity and other cephalosporin antibiotics Is the first choice for treatment.