剖宫产术中应用头孢类抗生素对生殖道菌群的影响  

Effects of Elective Cesarean Section and Antibiotics to the Bacterial Flora in Female Genital Tract

作　　者：丁红[1] 王蕴慧[1] 刘新质[1] 张睿[1] 李红玉[2] 

机构地区：[1]中山医科大学孙逸仙纪念医院妇产科,广州510120 [2]中山医科大学孙逸仙纪念医院细菌室,广州510120

出　　处：《中华妇产科杂志》2000年第6期342-344,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨择期剖宫产术中应用头孢类抗生素对生殖道菌群的影响。方法　将 45例择期剖宫产者随机分为 3组 :A组 15例 ,手术前、后均不应用任何抗生素 ;B组 15例 ,术后常规应用头孢类抗生素 3d ;C组 15例 ,术中一次性应用头孢类抗生素。每例分别在术前、术后行阴道液、宫腔液细菌培养 ,观察手术前、后生殖道菌群变化和术后感染情况。结果　患者术前生殖道细菌培养的阳性率为 35 .71% ,术后为 6 4.2 9% (P <0 .0 1)。A组手术前生殖道中的厌氧菌和需氧菌比例为 10∶3,术后二者比例为 18∶16 ,手术前、后均以厌氧菌为多 ,B、C两组术后的需氧菌株数 ( 2 7株 )多于厌氧菌 ( 2 0株 )。 3组间术后宫腔细菌培养阳性率接近 ,术后感染率均为 6 .6 7%。但C组术后阴道、宫腔的菌株数较A、B组为少。结论　剖宫产术中应用抗生素容易出现生殖道菌群失调。剖宫产术后应合理应用抗生素 ,为减少其对生殖道正常菌群的影响 。Objective To study the effects of elective cesarean section and antibiotics to the bacterial flora in the normal female genital tract. Methods Forty-five cases of elective cesarean section were randomly divided into 3 groups: no antibiotic was given (group A), one antibiotic was given for three days (group B), and only once antibiotic was used (group C). Bacterial cultures of vaginal swab and specimens aspirated from uterine cavity were performed in each case before and after operation to supervise the changes of bacterial flora in genital tract and postoperative infection. Results The positive rate of bacterial culture was 35.71% before operation but 64.29% after operation (P<0.01). The numbers of aerobe and anaerobe were 3 and 10 strains, respectively, before operation, and 16 and 18 strains after operation. The counts of anaerobe were more than those of aerobe in group A either before or after operation in group A. The counts of aerobe, on the other hand, were more than those of anaerobe both in group B and C after operation. The rates of positive bacterial culture in uterine cavity after operation were similar among the three groups (P>0.05). Interestingly the operative infection rates were 6.67% evenly. Conclusions Both cesarean section and antibiotics may disturb the bacterial flora in the normal female genital tract. The disturbance may increase the chance for flora imbalance and the postoperative infection. There was a great need for rational application of prophylactic antibiotics after cesarean section. Singledose antibiotic during cesarean section should be advocated.

关 键 词：剖宫产术 头孢菌素类 产褥期感染 

分 类 号：R719.8[医药卫生—妇产科学]