在多胎剖腹产中手术部位感染
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72205, USA. jfixler@uams.edu.
Archives of gynecology and obstetrics
|March 6, 2024
概括
与单胎分娩相比,多胎剖腹产不会增加手术部位感染 (SSI) 的风险. 然而,诸如长时间膜破裂,劳动增强和胆 ?? 膜炎等因素与多胎儿病例中SSI比率更高有关.
科学领域:
- 产科和妇科 产科和妇科
- 外科手术的安全性
- 传染病流行病学 传染病流行病学
背景情况:
- 剖腹产后手术部位感染 (SSI) 率是一个重大问题.
- 剖腹产后多胎妊娠对SSI风险的具体影响仍然不完全理解.
- 澄清这种关系对于优化手术实践和患者护理至关重要.
研究的目的:
- 调查多胎剖腹产是否与单胎剖腹产相比,与手术部位感染 (SSI) 的更高发病率有关.
- 在多胎剖腹产的背景下,确定导致SSI的临床因素.
主要方法:
- 追溯队列研究分析了从2009年10月到2018年12月在第三级医院的剖腹产.
- 主要结局是SSI的速度,将多胎妊娠与单胎妊娠进行比较.
- 统计分析包括单变量和多变量后勤回归,以确定SSI的独立风险因素.
主要成果:
- 总共有34,340例剖腹产被审查;1,129例是多胎 (3.3%) 和33,211例是单胎 (96.7%).
- 在多胎 (1.3%) 和单胎 (1.5%) 剖腹产 (p=0.670) 之间没有观察到SSI率的统计学上显著差异.
- 在多胎儿分娩中,长时间的膜破裂,劳动增强和胆膜炎与增加的SSI风险显著相关.
结论:
- 多胎剖腹产与单胎剖腹产相比,与手术部位感染的风险增加无关.
- 特定的产科条件,包括膜炎,长时间的膜破裂和劳动增强,是多胎剖腹产中SSI的独立风险因素.
- 目前关于抗生素预防的做法可能不需要仅基于多胎妊娠进行调整,但需要注意这些已识别的风险因素.
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