van der Ent C K, Joosten K F, Tielens A W, Gerards L J
Universiteitskliniek Wilhelmina Kinderziekenhuis, afd Kindergeneeskunde, Utrecht.
Ned Tijdschr Geneeskd. 1992 Sep 19;136(38):1858-61.
We retrospectively studied our strategy in 80 full-term newborns, born more than 24 hours after rupture of amniotic membranes. Six patients developed clinical signs of sepsis, in four of them sepsis was proven by a positive blood culture. In all cases, clinical symptoms were the first sign of infection. Routine laboratory tests (CRP, leucocyte counts and differentiation, thrombocyte counts) and microbiological investigations (surface cultures, cord blood cultures) were not helpful for the diagnosis of infection at an early stage. These findings are in accordance with the literature. We conclude that after prolonged rupture of membranes with full-term newborns postnatal paediatric care can be limited to a close observation period of 48 hours. There is no need for any further routine investigation of infants without clinical signs of infection.
我们回顾性研究了80例足月新生儿的治疗策略，这些新生儿在胎膜破裂24小时后出生。6例出现败血症临床症状，其中4例血培养阳性证实为败血症。在所有病例中，临床症状是感染的首发迹象。常规实验室检查（C反应蛋白、白细胞计数及分类、血小板计数）和微生物学检查（表面培养、脐血培养）对早期感染诊断并无帮助。这些发现与文献一致。我们得出结论，对于足月新生儿胎膜破裂时间延长的情况，产后儿科护理可限于48小时的密切观察期。对于没有感染临床症状的婴儿，无需进行任何进一步的常规检查。
