剖宫产抗生素合理应用的临床分析

Clinical analysis of perioperative prophylactic use of antibiotics for cesarean

目的探讨剖宫产围手术期抗菌药物预防感染的效果。方法将南京军区福州总医院2011年1至12月接受剖宫产手术的产妇600例随机分为两组,每组各300例。A组于术中断脐后立即给予头孢一代(头孢硫脒)2g静滴,术后12小时再给同等剂量滴注1次;B组于术后给予头孢二代(头孢替安)2g静滴,每日2次,连用4天。比较两组临床效果及费用等情况。结果两组术后最高体温、切口感染、院内感染无显著性差异(均P>0.05)。A组抗生素费用约280元,B组抗生素费用约1 050元,A组明显少于B组(F=42.547,P<0.01)。结论剖宫产围手术期通过使用价格昂贵的广谱头孢类抗生素及延长抗菌药物的使用时间,并不能提高术后预防感染的效果,头孢一代术中预防性给药不失为一种合理有效又经济的预防措施。

Objective To investigate the effect of perioperative prophylactic use of antibiotics for cesarean .Methods Totally 600 parturients who accepted cesarean in the period of January to December 2011 in Fuzhou General Hospital were randomly divided into two groups, 300 cases in each group.Group A was given first-generation cephalosporin （cefathiamidine） 2g intravenous drip immediately after cutting off the umbilical cord , and the same dose was given again after 12 hours.Group B were given second-generation cephalosporin （cefotiam） 2g intravenous drip after surgery, twice a day for 4 days.The clinical efficacy and costs of two groups were compared .Results After operation there were no significant differences in highest temperature , infection of incision and nosocomial infection （all P＆gt;0.05）. The medical cost of group A and group B was 280 Yuan and 1 050 Yuan, respectively （F=42.547,P＆lt;0.01）.Conclusion Using expensive broad-spectrum cephalosporin antibiotics and extending the duration of antimicrobial agents using in perioperative cesarean section can not improve the effect of postoperative infection prevention .First-generation cephalosporin preventive medication can be regarded as a kind of reasonable , effective and economical preventive measure .