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目的探究妊娠晚期孕妇B族溶血性链球菌感染对孕产妇凝血功能及母婴结局的影响。方法选择2014年12月-2015年10月在医院产检的孕妇320例,均经B超检查进行确认、核对,依据孕妇是否存在B族溶血性链球菌感染将其划分为B族溶血性链球菌感染阳性组29例,阴性组58例(依据其就诊时ID号码,从291例B族溶血性链球菌阴性的产妇中随机选择58例),观察凝血功能及母婴结局。结果 320例孕妇中检测出B族溶血性链球菌感染阳性患者29例,阳性率为9.06%;阳性组除血浆凝血酶时间(TT)外,血浆凝血酶原时间(PT)(9.67±1.13)s、国际标准化比率(INR)(0.95±0.07)及活化部分凝血活酶时间(APTT)(25.69±3.65)s与阴性组比较均明显缩短,而纤维蛋白原(Fbg)(3.89±1.68)g/L与阴性组比较明显增高(P<0.05);29例感染阳性孕妇中2例发生胎膜早破,发生率6.90%,58例阴性孕妇中3例发生胎膜早破,发生率5.17%,两组无统计学差异;阳性组孕妇剖宫产率和胎儿窘迫发生率、新生儿窒息发生率和病理学黄疸发生率,明显高于阴性组(P<0.05)。结论密切观察B族溶血性链球菌感染孕妇的凝血功能情况,可在一定程度上预防弥散性血管内凝血(DIC)出血性疾病,同时对妊娠晚期孕妇给予适量抗菌药物,对于降低妊娠孕妇和新生儿相关并发症,保证孕妇和新生儿的生命安全具有重要意义。
Objective To investigate the influence of hemolytic streptococci in pregnant women of late pregnancy on the coagulation function and maternal and infant outcomes in pregnant women. Methods A total of 320 pregnant women were examined in our hospital from December 2014 to October 2015. All patients were confirmed by B-mode ultrasound examination and classified according to the presence of B hemolytic streptococcal infection in pregnant women. 29 cases were positive for infection, and 58 cases were negative (58 cases were randomly selected from 291 cases of negative hemolytic streptococcal mothers according to their ID number). The coagulation function and maternal and infant outcomes were observed. Results Among the 320 cases of pregnant women, 29 cases were positive for B streptococcal infection, the positive rate was 9.06%. The positive rate of plasma prothrombin time (PT) was 9.67 ± 1.13 in addition to the plasma thrombin time (TT) s, F (0.95 ± 0.07), and APTT (25.69 ± 3.65) s were significantly shorter than those in the negative group, while Fbg (3.89 ± 1.68) g / L and the negative group was significantly higher (P <0.05); 29 cases of positive pregnant women in 2 cases of premature rupture of membranes, the incidence of 6.90%, 58 cases of negative pregnant women in 3 cases of premature rupture of membranes, the incidence rate of 5.17% . There was no significant difference between the two groups. The incidence of cesarean section and fetal distress, neonatal asphyxia and pathological jaundice in the positive group were significantly higher than those in the negative group (P <0.05). Conclusions The close observation of coagulation function of hemolytic streptococcus infection in pregnant women can prevent DIC hemorrhagic disease to a certain extent and give moderate doses of antibacterial drugs to pregnant women in the third trimester of pregnancy. Child-related complications, to ensure the safety of pregnant women and newborns is of great significance.