探讨未足月胎膜早破(PPROM)不同孕周的临床处理方式及对母儿结局的影响。

回顾分析重庆市妇幼保健院1995年1月至2005年10月因未足月胎膜早破而早产的620例不同孕周患者的临床处理方式及对母儿结局的影响。本结果采用χ²分析法。

28～31^＋6孕周未足月胎膜早破患者保胎治疗，容易导致宫内感染，但能降低新生儿死亡率(P<0.05)。32～33^＋6孕周未足月胎膜早破保胎组的宫内感染率、剖宫产率高于非保胎组(P<0.05)，而新生儿呼吸窘迫综合征(NRDS)的发生率低于非保胎组(P<0.05)。34～36^＋6孕周未足月胎膜早破患者保胎，除导致宫内感染率增加及剖宫产率增加外(P<0.05)，其余指标与前两者比较，差异无显著意义(P>0.05)。

对不同孕周未足月胎膜早破患者的处理有不同策略。由于医疗条件和水平的不同，国内对不同孕周未足月胎膜早破患者的临床处理观点与国外存在一定差异。

To discuss the treatment and outcomes of mother and neonate of pregnant patients with preterm premature rupture of membranes(PPROM) at the different gestational weeks.

The data of 620 preterm premature rupture of membranes with preterm birth from January 1995 to October 2005 were analyzed retrospectively, and were analyzed by χ² method.

For the preterm premature rupture of membranes with 28~31^{+ 6} gestational weeks, the expectant management could increase the intrauterine infection risks(P<0.05), but could decrease the death rate of the neonate(P<0.05). For the preterm premature rupture of membranes with 32~33^{+ 6} gestational weeks, intrauterine infection risks and the caesarean rate increased also by the expectant management(P<0.05), but the neonatal respiratory distress syndrome (NRDS) rate decreased(P<0.05). For the preterm premature rupture of membranes with 34~36^{+ 6} gestational weeks, there were no obvious differences between the expectant group and the contrast group, except increased intrauterine infection risks and the caesarean rate(P<0.05).

There were different clinical management for different gestational weeks with preterm premature rupture of membranes, and there were differences also of clinical opinions from overseas for different medical conditions and techniques.