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目的 探讨有关羊水Ⅲ°污染和胎膜早破 >2 4小时的新生儿生后预防性应用抗生素与感染发病的关系。方法1996年 3月～ 1998年 4月本院出生的 2 47例羊水Ⅲ°污染和 117例胎膜早破 >2 4小时的新生儿分别设为Ⅰ组和Ⅱ组 ,生后不论有无感染均肌注头孢氨噻肟 10 0mg/ (kg·d)共 5天 ,用药前做腔道 (眼、鼻、耳、咽 )分泌物培养 ,部分新生儿加做血培养。同期出生无以上二种情况的新生儿 2 5 13例作为对照组。结果 对照组发生感染 45例 ,发病率 1.79%。Ⅰ组发生感染 14例 ,发病率 5 .66% ,明显高于对照组 ( χ2 =16.16,P <0 .0 1)。Ⅱ组发生感染 1例 ,发病率 0 .85 % ,与对照组比较无显著差异 ( χ2 =0 .5 7,P >0 .0 5 )。结论 胎膜早破疑有宫内感染的新生儿生后预防性用抗生素可降低感染发病率 ,而羊水Ⅲ°污染有胎窘、产时窒息的新生儿生后尽管应用抗生素仍不能降低感染的发病率 ,故预防重点是防止胎窘和产时窒息发生
Objective To investigate the relationship between prophylactic use of antibiotics and the pathogenesis of neonatal post-natal neonates with Ⅲ ° amniotic fluid contamination and premature rupture of membranes. Methods From March 1996 to April 1998, 247 neonates with Ⅲ ° contamination of amniotic fluid and 117 cases of premature rupture of membranes (MPL)> 24 hours were randomly assigned to group Ⅰ and group Ⅱ, with or without infection after birth Both intramuscular injection cefotaxime 10 0mg / (kg · d) for 5 days, before the medication cavity (eyes, nose, ears, pharynx) secretions culture, some newborn blood culture. In the same period, 2513 newborns without the above two conditions were taken as the control group. Results The control group had 45 cases of infection, the incidence rate was 1.79%. In group Ⅰ, infection occurred in 14 cases, the incidence was 5.66%, which was significantly higher than that in control group (χ2 = 16.16, P <0.01). There was 1 case of infection in group Ⅱ, the incidence rate was 0.85%. There was no significant difference between the two groups (χ2 = 0.57, P> 0.05). Conclusion Premature rupture of membranes in neonates with intrauterine infection after prophylaxis with antibiotics can reduce the incidence of infection, and amniotic fluid Ⅲ ° contamination of fetal embarrassment, neonatal aspartate during labor even though the use of antibiotics can not reduce the infection Incidence, so the focus of prevention is to prevent fetal embolism and childbirth during asphyxia