抗菌药物预防使用时机对剖宫产患者术后感染的影响  

Effects of Prophylactic Use Timing of Antibiotics on Postoperative Infection of Cesarean Section Patients

作　　者：杨思芸[1] 李林[1] 张利平[1] 唐志立[1] 苏强[1] 朱丽莎[1] 

机构地区：[1]南充市中心医院/川北医学院第二临床医学院,四川南充637000

出　　处：《中国药房》2017年第2期219-221,共3页China Pharmacy

基　　金：四川省基层卫生事业发展研究中心重点项目(No.SJWF1401)

摘　　要：目的:探讨抗菌药物预防使用时机对剖宫产患者术后感染的影响。方法:选择择期行剖宫产患者100例,按随机数字表法分为观察组和对照组,各50例。两组患者均择期行剖宫产术。对照组患者于胎儿断脐后立即给予注射用头孢硫脒2.0 g,静脉注射,术后6 h内再给予2.0 g,静脉注射;观察组患者切皮前0.5~2 h给予注射用头孢硫脒2.0 g,静脉注射,术后6 h内再给予2.0g,静脉注射。比较两组患者手术时间、术中失血量、抗菌药物预防应用时间及术后6、12、24、48 h体温,术后48 h白细胞、中性粒细胞水平,以及术后子宫内膜炎、切口感染、尿路感染、产褥病等并发症的发生率。结果:两组患者手术时间、术中失血量及术后6、12、24、48 h体温,术后48 h白细胞、中性粒细胞水平比较,差异均无统计学意义(P>0.05);对照组患者抗菌药物预防应用时间[(4.8±1.60)h]明显短于观察组[(5.5±1.65)h],差异有统计学意义(P<0.05)。两组患者术后子宫内膜炎(0 vs.2.00%)、伤口感染(0 vs.0)、尿路感染(2.00%vs.2.00%)、产褥病(4.00%vs.6.00%)发生率比较,差异均无统计学意义(P>0.05)。结论:切皮前和断脐后使用抗菌药物对剖宫产患者术后感染预防效果相当,但切皮前用药延长了抗菌药物预防时间。OBJECTIVE： To explore the effects of prophylactic use timing of antibiotics on postoperative infection of cesarean section patients. METHODS： 100 patients undergoing selective cesarean section were divided into observation group and control group according to random number table, with 50 cases in each group. Both groups received selective cesarean section. Control group was given Cefathiamidine for injection 2.0 g intravenously immediately after cutting umbilical cord of fetus, and then given another 2.0 g intravenously within 6 h after surgery. Observation group was given Cefathiamidine for injection 2.0 g intravenously 0.5-2 h before skin incision, and then given another 2.0 g intravenously 6 h after surgery. Surgery duration, intraoperative blood loss, prophylactic duration of antibiotics were compared between 2 groups as well as body temperature 6, 12, 24, 48 h after surgery, leukocyte and neutrophile granulocyte 48 h after surgery; the incidence of complication such as endometrial inflammation, incision infection, symptomatic urinary tract infection, puerperal disease were compared between 2 groups after surgery. RESULTS： There was no statistical significance in surgery duration and intraoperative blood loss as well as body temperature 6, 12, 24, 48 h after surgery, leukocyte and neutrophile granulocyte 48 h after surgery between 2 groups （P〉0.05）. The prophylactic duration of antibiotics in control group [（4.8± 1.60）h] was shorter than observation group [（5.5± 1.65）h], with statistical significance （P〈0.05）. There was no statistical significance in the incidence of endometrial inflammation （0 vs. 2.00% ）, incision infection （0 vs. 0）, urinary tract infection （2.00% vs. 2.00%）, puerperal disease （4.00% vs. 6.00%） between 2 groups （P〉0.05）. CONCLUSIONS： The use of antibiotics before skin incision is similar to that after cutting umbilical cord in preventive effects of postoperative infection for cesarean section patients. The use of antibiotics before skin i

关 键 词：剖宫产术 抗菌药物 用药时机 术后感染 头孢硫脒 

分 类 号：R978.1[医药卫生—药品] R719.8[医药卫生—药学]