剖宫产围术期预防性应用头孢呋辛的时间对术后感染的影响  

Effect of Time of Perioperative Prophylactic Use of Cefuroxime on Postoperative Infection After Cesarean Section

作　　者：孟康 邵华 范永周 王惠 苑海[1] 方青 MENG Kang;SHAO Hua;FAN Yongzhou;WANG Hui;YUAN Hai;FANG Qing(Baoding Maternal and Child Health Hospital,Baoding,Hebei,China 071000;Baoding Second Hospital,Baoding,Hebei,China 071051)

机构地区：[1]河北省保定市妇幼保健院,河北保定071000 [2]河北省保定市第二医院,河北保定071051

出　　处：《中国药业》2021年第24期104-107,共4页China Pharmaceuticals

基　　金：河北省保定市科技计划项目[2041ZF277]。

摘　　要：目的探讨剖宫产围术期预防性应用头孢呋辛的时间对术后感染的影响。方法选取保定市妇幼保健院2019年10月至2020年12月顺利完成剖宫产手术的产妇203例,按预防性应用头孢呋辛时间的不同分为A组(101例)和B组(102例),两组产妇术前30min均静脉滴注注射用头孢呋辛钠,术后A组续用48h,B组续用72h,均每次1.5g,每12h1次。结果与术前比较,两组产妇术后72h的γ干扰素、肿瘤坏死因子-α、C反应蛋白、中性粒细胞百分比、白细胞计数水平均明显降低,且B组明显低于A组(P<0.05);B组产妇体温复常时间和住院时间均明显短于A组,术后72h的发热率、产褥感染率和切口感染率均明显低于A组(P<0.05)。且随产妇体质量的增加,两组发热率和感染率均明显升高(P<0.05)。结论剖宫产围术期预防性静脉滴注头孢呋辛能快速改善炎性因子和感染指标水平,且术后用药至72h的效果优于48h。同时,随着产妇体质量的增加应相应增加头孢呋辛的用量。Objective To investigate the effect of the time of perioperative prophylactic use of cefuroxime on postoperative infection after cesarean section.Methods A total of 203 puerperant women who underwent cesarean section in the Baoding Maternal and Child Health Hospital from October 2019 to December 2020 were selected and divided into group A(101 cases)and group B(102 cases)according to the time of prophylactic use of cefuroxime.At 30 min before the operation,Cefuroxime for Injection was injected intravenously in the two groups.After the operation,Cefuroxime for Injection was continuously injected intravenously for 48 h in group A and 72 h in group B,1.5 g each time,once every 12 h.Results At 72 h after the operation,the levels of interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),neutrophil(NEUT)percentage and white blood cell count(WBC)in the two groups were significantly lower than those before the operation,and those in group B were significantly lower than those in group A(P<0.05).The recovery time of body temperature and length of hospital stay in group B were significantly shorter than those in group A,and the fever rate,puerperal infection rate and incision infection rate in group B were significantly lower than those in group A at 72 h after operation(P<0.05).With the increase of body weight,the fever rate and infection rate in the two groups increased significantly(P<0.05).Conclusion Perioperative prophylactic intravenous infusion of cefuroxime after cesarean section can quickly improve the levels of inflammatory factors and infection indexes,and the effect of Cefuroxime for Injection after 72 h was better than that after 48 h.Meanwhile,the dosage of cefuroxime should be increased with the increase of body weight.

关 键 词：头孢呋辛 用药时间 剖宫产 围术期 术后 预防感染 

分 类 号：R969.4[医药卫生—药理学] R978.1[医药卫生—药学]