产前预防性使用抗菌药物对高危产妇产褥期感染及新生儿评分的影响  

Effect of prenatal prophylactic use of antibiotics on puerperal infection and neonatal scores of high-risk puerpera

作　　者：郭银华 韩雅男 王晶[1] 韩丽[3] GUO Yin-hua;HAN Ya-nan;WANG Jing;HAN Li(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110000,China)

机构地区：[1]中国医科大学附属盛京医院第一重症监护病房,辽宁沈阳110000 [2]中国医科大学附属盛京医院第二重症监护病房,辽宁沈阳110000 [3]中国医科大学附属盛京医院第六普通外科,辽宁沈阳110000

出　　处：《中华医院感染学杂志》2023年第17期2698-2701,共4页Chinese Journal of Nosocomiology

基　　金：中华国际医学交流基金会项目(Z-2016-23-1823-11)。

摘　　要：目的探讨产前预防性使用抗菌药物对高危产妇产褥期感染及新生儿评分的影响.方法选取2019年1月-2022年1月在中国医科大学附属盛京医院妇产科生产的高危产妇296例为研究对象,随机数字表法分为研究组和对照组,每组148例.研究组和对照组分别于产前30 min和产后给予静注头孢唑林钠.比较两组产妇的生产情况、感染相关指标水平、不良反应及新生儿状况.结果两组产妇的高危因素比较无统计学差异,年龄>35岁、妊娠期高血压、胎位不正均是主要的高危因素;研究组分娩时出血量和产后24 h出血量均少于对照组,且住院时间更短(P<0.05);研究组分娩并发症发生率为6.1%(9/148)与对照组分娩并发症发生率为8.1%(12/148),比较差异无统计学意义(χ^(2)=0.461,P=0.497);研究组产后白细胞计数、中性粒细胞水平均低于对照组(P<0.05);研究组不良反应发生率6.08%(9/148)低于对照组16.22%(24/148)(P<0.05),常见的不良反应包括胃肠道反应、皮疹等;研究组新生儿轻度窒息发生率低于对照组(P<0.05),且研究组新生儿1 min、5 min Apgar评分较对照组均有改善(P<0.05).结论抗菌药物预防性应用可以降低高危产妇产褥期感染相关指标,缩短住院时间,改善新生儿评分,且不良反应发生率较低,具有临床推广参考价值.OBJECTIVE To explore the effect of prenatal prophylactic use of antibiotics on puerperal infection and neonatal scores of the high-risk puerpera.METHODS A total of 296 high-risk puerpera who gave birth in obstetrics and gynecology department of Shengjing Hospital Affiliated to China Medical University from Jan 2019 to Jan 2022 were recruited as the research subjects and were randomly divided into the study group and the control group,with 148 cases in each group.The study group was treated with intravenous injection of cefazolin 30 min before the labor,while the control group was treated with intravenous injection of cefazolin after the labor.The status of labor,infection-related indexes,adverse reactions and neonatal status were observed and compared between the two groups of puerpera.RESULTS There were no significant differences in the high risk factors between the two groups.The more than 35 years of age,gestational hypertension and malposition were the major high risk factors.The blood loss volume at the labor and 24 hours after the labor were less in the study group than in the control group,and the length of hospital stay of the study group was shorter than that of the control group(P<0.05).The incidence of complications was 6.1%(9/148)in the study group,8.1%(12/148)in the control group,and there was no significant difference(χ^(2)=0.461,P=0.497).The levels of white blood cell and neutrophils of the study group were lower than those of the control group(P<0.05).The incidence of adverse reactions of the study group was 6.08%(9/148),lower than 16.22%(24/148)of the control group(P<0.05).The common adverse reactions included gastrointestinal tract reactions and rash;the incidence of mild asphyxia of neonates of the study group was lower than that of the control group(P<0.05),and the 1 min and 5 min Apgar scores of neonates were improved more significantly in the study group than in the control group(P<0.05).CONCLUSION The prophylactic use of antibiotics may reduce the infection-related indexes of the high-risk

关 键 词：抗菌药物 预防应用 高危产妇 产褥感染 新生儿评分 不良反应 

分 类 号：R714.62[医药卫生—妇产科学]