剖宫产术后严重感染经验治疗的调查  

Investigation of empiric therapy on postoperative severe infection after cesarean section

作　　者：庞晓军[1] 陈英 

机构地区：[1]钦州市第二人民医院临床药学科,广西钦州535000 [2]广西区人民医院药学部,广西南宁530021

出　　处：《中华医院感染学杂志》2013年第23期5787-5788,5800,共3页Chinese Journal of Nosocomiology

基　　金：广西科学研究与技术开发基金项目(桂科攻0993003B-29)

摘　　要：目的探讨了解哌拉西林/他唑巴坦联合米诺环素治疗剖宫产术后严重感染的效果,以提高治疗成功率。方法选取施行剖宫产术后确诊严重感染患者65例,随机分为两组,治疗组32例根据临床药师建议采用哌拉西林/他唑巴坦4.5g,静脉滴注,8h1次联合米诺环素片首剂0.2g,随后0.1g鼻饲给予,12h1次,同时采用血必净注射液50ml,静脉滴注,12h1次抑制炎症级联反应改善局部循环,主管医师皆接受会诊意见,对照组33例采用头孢西丁2g,静脉滴注,8h1次联合多西环素片首剂0.2g,随后0.1g鼻饲给予,12h1次;两组用药期间禁止母乳喂养,并在停药4d后方可行母乳喂养。结果总有效率治疗组为100.00%、对照组为75.76%,炎症指标改善治疗组优于对照组,差异有统计学意义(P<0.05)。结论临床药师应根据病原菌流行病学资料和耐药模式以及病情选择治疗药物,可提高剖宫产术后严重感染的治疗成功率。OBJECTIVE To discusses the effect of piperacillin /tazobactam with the combination of minocyline on the treatment of postoperative severe infection after cesarean section in order to improve the success rate of treatment. METHODS A total of 65 patients were selected with postoperative severe infection after receiving the cesarean section, and were randomly divided into two groups. 32 patients in the treatment group were suggested to be treated with 4.5 g of piperacillin/tazobactam by clinical pharmacist, iv drip, q8h, with the combination of minocycline tablets, the first dose was 0.2g, and received nasal feeding of 0.1 g subsequently, q12h. The patients were simultaneously given 50ml Xuebijing Injection, ivdrip, ql2h to inhibit the inflammatory cascade reaction in order to improve the local circulation, and all the consultation comments were received by the primary physician. 33 patients in the control group were treated with 2 g of cefoxitin, ivdrip, q8h, with the combination of doxycyc-line tablets, the first dose was 0.＇2 g, and received nasal feeding of 0.1 g subsequently,q12h. Breast feeding was prohibited during the treatment in the two grotips, and was allowed after 4 days of discontinuation. RESULTS Overall effective rates in the treatment group were 100.00%, and 75.76 % in the control group; the inflammatory index improvement was better in the treatment group than the control group, and the differences had statistical significance （P〈0.05）. CONCLUSION The clinical pharmacist should select the treatment drugs according to the pathogen epidemiologic data and drug resistance pattern as well as the condition of the disease, which can increase the success rate of treatment on patients with postoperative severe infection after cesarean section.

关 键 词：哌拉西林 他唑巴坦 米诺环素 剖宫产 术后严重感染 

分 类 号：R978.1[医药卫生—药品]