一代头孢菌素单剂预防剖宫产手术部位感染干预效果评价  

Evaluation of Preventative Effect of Surgical Site Infection by First Generation of Cephalosporin in Cesarean Section

作　　者：陈静[1] 宁淑敏[1] 张玉荣[1] 臧凤英[1] 赵莉[1] 周辉[1] 曹武奎[1] 宋诗铎[2] 高斌[1,2] 

机构地区：[1]天津市传染病医院妇产科,天津300192 [2]天津市感染性疾病研究所,天津300072

出　　处：《中华医院感染学杂志》2010年第20期3204-3206,共3页Chinese Journal of Nosocomiology

基　　金：与法国里尔大学医学院附属地区中心医院合作项目(2005.5002)

摘　　要：目的评价干预剖宫产围手术期预防性使用抗菌药物的临床效果。方法循证制定剖宫产围手术期抗菌药物预防性使用指南、推荐术中予以单剂一代头孢菌素;干预后前瞻性调查130例与干预前等量随机回顾调查,对两组手术部位感染、术后子宫内膜炎、术后病率、抗菌药物的费用等进行比较。结果干预前(术前0.5h给予三代头孢菌素,术后联合甲硝唑,至少48h)、干预后手术部位感染发生率均为1.54%;产褥病率分别为3.08%、2.31%;两种策略所用抗菌药物的支出分别为(179.79±51.79)元和(14.96±15.19)元(P=0.00)。结论一代头孢菌素钳夹脐带时单剂给药作为剖宫产围手术期预防性使用抗菌药物,与之前的三代头孢菌素联合甲硝唑术后长程预防策略相比,显示手术相关感染控制效果相当,抗菌药物费用显著下降。OBJECTIVE To evaluate the clinical effect on prophylactic antibiotics in cesarean delivery.METHODS The intervention including evidence-based guideline of prophylactic use of antimicrobial for cesarean section single-dose of the first generation cephalosporins at cord clamping was performed to increase in post-discharge surveillance as a strategy to reassure surgeons of the safety of the reduction.A retrospective investigation of antimicrobial consumption,endometritis,surgical site infections（SSIs）and postoperative incidence between the pre and post operation were performed randomly to comparison of the intervention.RESULTS The SSIs rates before and after the intervention were 1.54%,and the incidence rates of post intervention were 3.08% and 2.31%,respectively.There was about 90% cost reduction in prophylactic antimicrobial use on average per cesarean section after the intervention（RMB 179.79±51.79 to RMB 14.96±15.19,P=0.00）.CONCLUSION The intervention of the first generation of cephalosporins by single-dose use administrated after cord clamping is safe and more unexpensive compared with the previous stractegy of third generation of cephalosporin plus metronidazde long use.

关 键 词：剖宫产 手术部位感染 抗菌药物 预防性使用 干预效果 

分 类 号：R978.1[医药卫生—药品]