剖宫产围术期不同时期应用抗菌药物疗效观察

Clinical efficacy of antibiotic use at different time of perioperative period of cesarean section

目的探讨剖宫产围术期不同时期应用抗菌药物的临床效果,为剖宫产围术期合理使用抗菌药物提供参考。方法选取2009年1月-2011年7月医院妇产科行剖宫产手术的1502例产妇作为研究对象,根据抗菌药物使用时期不同分为术前组872例及术后组630例;术前组患者在术前30min单次给予头孢呋辛2.0g静脉滴注,术后组患者在术后使用头孢呋辛2.0g静脉滴注,2次/d,连用3d;头孢呋辛过敏患者使用林可霉素1.8g静脉滴注。结果术前组使用头孢呋辛者占74.88%,术后组使用头孢呋辛者占71.90%,两组抗菌药物使用种类方面比较差异无统计学意义;术前组术后感染率0.69%,术后发病率1.26%;术后组术后感染率1.27%,术后发病率10.63%,两组患者术后感染率比较差异无统计学意义,术后发病率比较差异有统计学意义(P<0.05);术后3d两组白细胞计数比较差异无统计学意义;体温恢复时间、术后住院天数术前组为(38.49±12.35)h、(4.81±1.15)d,术后组为(50.32±24.18)h、(5.24±1.37)d,比较差异有统计学意义(P<0.05)。结论剖宫产术前使用抗菌药物能明显降低术后发病率,较术后使用更具有较好效果。

OBJECTIVE To investigate the clinical effect of the use of antimicrobial drugs at different time during the perioperative period of the cesarean section so as to guide the rational use of antibiotics during the perioperative period of the cesarean section. METHODS A total of 1502 cases of maternal who underwent the cesarean section in the hospital from Jan 2009 to Jul 2011 were selected as the study objects, according to the use of antimicrobial agents at different periods, the objects were divided into the preoperative group of 872 cases and the postoperative group of 630 cases. The preoperative group was given the cefuroxime needles 2.0 g intravenously 30 rain before the surgery, while the postoperative group received the cefuroxime needles 2.0 g intravenously, 2 times / d for 3 consecutive days; the cefuroxime allergy sufferers were given the lincomycin 1.8 g intravenously. RESULTS The participants who took the cefuroxime accounted for 74. 88% in the preoperative group, 71. 90% in the postoperative group; the difference in the type of used antibiotics was not statistically significant ; the incidence rate of the postoperative infections was 0. 69% in the preoperative group, 1.27% in the postoperative group; the postoperative morbidity was 1.26% in the preoperative group, 10.63% in the postoperative group , the difference in the incidence of postoperative infections between the two groups was not statistically significant, and the difference in the postoperative morbidity between the two groups was statistically significant （P〈0. 05）. The difference in the white blood cell count 3 days after the surgery between the two groups was not statistically significant . The temperature recovery time was （38.49 ±12.35）h in the preoperative group, （50.32±24.18）h in the postoperative group; the postoperative hospitalization duration was （4.81± 1.15） d in the preoperative group, （5.24±1.37） d in the postoperative group, the difference was statistically significant （P〈0.05）. CONCLUSION The use of antibiotics before the cesarean section can reduce the postoperative morbidity more significantly than does the postoperative use.