剖宫产前碘伏消毒阴道对预防子宫内膜炎的前瞻性研究  

Vaginal Preparation with Povidone-iodine Solution before Cesarean Section for Preventing Postpartum Endometritis: a Randomized Clinical Trial

作　　者：李金枝[1] 叶丹娟[1] 邢彦彦[1] 沈慧[1] 严浩[1] 左绪磊[1] 

机构地区：[1]复旦大学附属金山医院,上海201508

出　　处：《实用妇产科杂志》2013年第11期823-826,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨剖宫产前碘伏消毒阴道对产后子宫内膜炎有无预防作用。方法:选择2011年6月至2011年12月在我院行子宫下段剖宫产的患者191例,随机分为两组,研究组97例,对照组94例。研究组术前30分钟内以碘伏纱布消毒阴道,对照组不做任何处理。比较两组术后子宫内膜炎的发生率。结果:研究组发生子宫内膜炎13例,对照组发生20例,两组子宫内膜炎发生率比较差异无统计学意义(P=0.150)。胎膜早破患者中,研究组的子宫内膜炎发生率低于对照组,差异有统计学意义(P=0.048);胎膜未破患者中,两组子宫内膜炎发生率比较差异无统计学意义(P=0.835);无论是否临产,研究组和对照组子宫内膜炎发生率比较差异均无统计学意义(P=0.608,P=0.274)。腹部切口愈合不良研究组4例(4.1%),对照组6例(6.3%),两组切口愈合不良发生率比较差异无统计学意义(P=0.708).结论:剖宫产前碘伏消毒阴道可以降低胎膜早破患者子宫内膜炎的发生风险,但不降低腹部切口愈合不良的风险。Objective： To determine whethercleaning the vagina with povidone-iodine before cesarean should decrease the risk of postpartum endometritis. Methods ：191 women who underwent cesarean section from June to December in 2011 were enrolled and randomly assigned into study group（97 cases）and control group（94 cases）. The women in study group were given vaginal cleaning with povidone-iodine immediately before cesarean while the women in control group were treated without vaginal washing. The incidence of postpartum endometritis and wound morbidity were compared between the two groups. Results：13 cases in the study group and 20 cases in the control group developed endometritis, and the difference was not statisti- cally significant （ P = 0. 150）. For women with premature rupture of membrane, the study group had lower inci- dence of endometritis than the control group, and the difference was statistically significant （P = 0. 048）. For women with intact membrane, the incidence between the two groups was not statistically different （P = 0. 835）. The status of in labor or not didn＇t affect the risk of endometritis. The difference of wound morbidity between the two groups was not statistically significant （ P = 0. 708 ）. Conclusion： Vaginal preparation with povidone-iodine solution before cesarean section can decrease the risk of postpartum endometritis in women with premature rupture of membrane, but didn＇t decrease the risk of wound morbidity.

关 键 词：剖宫产 阴道消毒 子宫内膜炎 碘伏 

分 类 号：R711.32[医药卫生—妇产科学]