Abstract
Objective To investigate the effect of flushing uterine cavity with metronidazole and hydrogen peroxide solution combined with antibiotics on levels of white blood cell (WBC), C-reactive protein (CRP) and procalcitonin (PCT) in puerperal infected parturients. Methods From September 2016 to December 2018, a total of 120 parturients with puerperal infection in Chongqing Kaizhou District People’s Hospital were selected and divided into observation group and control group according to the random number table method, with 60 cases in each group. The pregnant women in control group were given conventional antibiotics by intravenous infusion of penicillin and oral ampicillin; while the cases in observation group were treated with metronidazole combined with hydrogen peroxide solution to wash the uterine cavity based on the conventional treatment. The levels of WBC, serum CRP and PCT were detected, respectively. Results There were no significant differences in WBC count, serum CRP and PCT levels of maternal whole blood at 1 d postpartum between the two groups (all P > 0.05). At the 3 d and 5 d postpartum, the WBC counts in the observation group were (9.39 ± 1.79) × 109/L and (6.93 ± 1.23) × 109/L, which were significantly lower than those of the control group (12.05 ± 2.33) × 109/L and (9.93 ± 1.94) × 109/L, respectively, with the significant differences (t = 7.03, P < 0.001; t = 10.05, P < 0.001). The maternal serum CRP levels in the observation group were (22.97 ± 10.57) mg/L and (15.42 ± 8.82) mg/L, respectively, which were lower than those of the control group (31.67 ± 12.59) mg/L and (20.86 ± 10.83) mg/L, respectively, with significant differences (t = 3.92, P< 0.001, t = 2.98, P = 0.01). At the 3 d and 5 d postpartum post-treatment, the serum PCT levels of the observation group were (2.87 ± 1.47) μg/L and (0.81 ± 0.50) μg/L, which were lower than those in the control group [(3.78 ± 1.90) μg/L and (1.68 ± 0.99) μg/L], with significant differences (t = 2.96, P = 0.01; t = 5.92, P < 0.001). The overall effective rate of maternal treatment in the observation group was 98.33% (59/60), which was significantly higher than that in the control group [80.00% (48/60)], with significant differences (χ2 = 10.44, P < 0.001). Multivariate Logistic regression analysis showed that treatment was a protective factor affecting the clinical efficacy of puerperal infection (OR = 0.35, 95%CI: 0.15-0.87, P < 0.01), but the history of vaginitis during pregnancy (OR = 3.49, 95%CI: 1.12-1.89, P = 0.01) and age (OR = 1.12, 95%CI: 1.02-1.19, P = 0.01) were both risk factors affecting the clinical efficacy of puerperal infection. Prolonged labor was not an independent risk factor for the clinical efficacy of puerperal infection (OR = 2.15, 95%CI: 1.01-5.11, P = 0.08). Conclusions When puerperal infection occurs, timely and effective anti-infection interventions were necessary. It was a protective factor affecting the clinical efficacy of puerperal infection. Metronidazole combined with hydrogen peroxide solution to wash uterine cavity combined with antibiotics was beneficial on patients with puerperal infection. Key words: Puerperal infection; Anti-infection; Leukocyte; C-reactive protein; Procalcitonin
Published Version
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