剖宫产围手术期预防性应用抗生素探讨

Study on Preventive Use of Antibiotics in Cesarean Section

目的探讨择期剖宫产围手术期预防性应用抗生素不同用药方法预防术后感染的效果。方法将住院符合研究条件的择期剖宫产产妇按顺序分奇数组:A组(围手术期用药组);偶数组:B组(传统术后用药组)。A组50例,选用头孢噻肟钠与替硝唑,于手术前30m in内单次静脉冲击给药,术中冲洗宫腔、子宫切口及腹腔留置;B组50例,术后头孢噻肟钠+替硝唑静脉滴注5d。结果术后最高体温、退热时间2组间差异有统计学意义(P<0.05);术后病率、腹部切口感染、子宫内膜炎2组间差异无统计学意义(P<0.05);术后不良反应中白细胞计数、胃肠道反应及药物性皮疹2组间差异无统计学意义(P>0.05)。结论围手术期使用抗生素是预防剖宫产术后感染安全、有效的理想方法。

Objective To study on the method for preventive use of antibiotics in cesarean section. Methods The gravidas were divided into two groups according to the different medications of prophylactic drugs. Groups A of 50 cases were given tinidazole and cefotaxime sodium in a single intravenous stoss medication in preoperative 30 minutes, douching the uterine cavity and uterine incision during operation, and retaining antibiotics in abdominal cavity postoperatively. Group B of 50 cases received tinidazole and cefotaxime sodium in postoperative 5 days. Results There existed significant differences in the highest postoperative temperature and pyretolytic time between the 2 groups （ P 〈 0.05 ）. There were no significant differences in postoperative morbidity,wound infection or endometritis between the 2 groups （ P 〉 0.05 ） ; no significant differences in adverse effects, WBC counts, gastroenteric trouble or drug rash between the 2 groups （ P 〉 0.05） ; but significant differences of average doses of antibiotics existed between them （ P 〉 0.05 ）. Conclusion Prophylactic application of antibiotics in peri- cesarean stage is safe, effective and may also reduce the consume of medicine.