剖宫产妇运用抗菌药物预防感染的临床研究  

Clinical research on antibiotics for prevention of infection after cesarean section

作　　者：高兰翠 王妍[2] 王惠[2] 卫兵[1] GAO Lan-cui WANG Yan WANG Hui WEI Bing(Second Affiliated Hospital of Anhui Medical University, Hefei , Anhui 230601, China)

机构地区：[1]安徽医科大学第二附属医院妇产科,安徽合肥230601 [2]皖北煤电集团总医院妇产科,安徽宿州234000

出　　处：《中华医院感染学杂志》2017年第7期1616-1619,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年科学基金资助项目(81100412)

摘　　要：目的探讨剖宫产妇预防感染的合理应用抗菌药物方法,为产妇临床用药提供科学参考依据。方法选择2015年6月-2016年1月4家三级甲等医院行腹膜内剖宫产妇100例,其中择期剖宫产组50例及急诊剖宫产组50例,每组根据头孢菌素类药物使用时间分为结扎前用药组和结扎后用药组,回顾性分析不同用药时机的产妇术后感染情况。结果在择期剖宫产病例中,脐带结扎前用药组的术后第一天最高体温,术后三天平均体温及术后体温恢复正常所需时间均显著低于脐带结扎后用药组(P<0.05),100例剖宫产10例发生感染,感染率为10.00%;在择期及非择期剖宫产病例中,脐带结扎前用药组的感染率显著低于脐带结扎后用药组(P<0.05),在所有剖宫产病例中,抗菌药物产生的费用,脐带结扎前用药组低于脐带结扎后用药组(P<0.05)。结论择期或急症剖宫产产妇脐带结扎前使用抗菌药物优于脐带结扎后,可以有效降低术后感染的发生,并减轻患者的经济负担。OBJECTIVE To explore the rational use of antimicrobial agents in cesarean section for prevention of in- fection, so as to provide scientific basis for clinical use of antimicrobial agents in maternal women. METHODS From Jun. 2015 to Jan. 2016, 100 cases of maternal women with intraperitoneal cesarean section from 4 tertiary hospitals in our province were selected, including elective cesarean section group （n= 50） and emergency cesarean section group （n=50）. According to the use time of cephalosporins, each group was divided into before ligation group and after ligation group. The postoperative infection was analyzed retrospectively. RESULTS In the elective cesarean section group, the highest temperature of the first day after operation, the average temperature of the three days after operation and the body temperature returned to normal after the operation in before ligation group were significantly lower than those in after ligation group （P〈0.05）. Totally 10 cases of infection occurred in 100 cases of cesarean section, with the infection rate of 10.00%. In the elective and non-elective cesarean section ca- ses, the infection rate of before ligation group was significantly lower than that of after ligation group （P〈0.05）. In all cases of cesarean section （elective and emergency cesarean section）, the cost of antibiotics in before ligation group was significantly lower than that in after ligation group （P〈0.05）. CONCLUSION The use of antibiotics before ligation is more effective than after ligation in elective or emergency cesarean section, which can both reduce the postoperative infection and the economic burden of patients.

关 键 词：用药时机 头孢菌素类 剖宫产 预防感染 

分 类 号：R978.11[医药卫生—药品]