头孢硫脒预防急诊剖宫产手术感染的临床观察

Clinical observation of using cefathiamidin to prevent infections in emergency cesarean delivery

目的探讨急诊剖宫产围手术期预防性应用头孢硫脒的临床疗效和安全性,为临床合理用药提供参考。方法 170例急诊剖宫产病例随机分为头孢硫脒组(A组)80例,头孢西丁组(B组)90例,A组:麻醉后、切皮前30min和术毕4h内各使用1次头孢硫脒2.0g+生理盐水250ml,快速静脉滴注,术后第1天头孢硫脒2.0g+生理盐水250ml静脉注射,每天2次,共1d,B组:术中、术后用药方法及用药时间同A组,对比两组患者相关指标的差异;采用SPSS13.0软件进行统计分析,计量资料用均数±标准差表示,采用t检验,计数资料采用χ2检验。结果 A组术后最高体温(37.51±0.40)℃,B组术后最高体温(37.36±0.31)℃,两组比较差异无统计学意义;A组术后白细胞升高率、术后第2天白细胞计数、中性粒细胞百分数分别为:57.5%、(12.95±3.47)×109/L、(80.83±7.09)%,B组分别为66.7%、(14.15±4.07)×109/L、(82.03±4.38)%,两组比较差异无统计学意义;A组术后到出院时间(3.59±0.68)d短于B组(3.64±0.49)d,两组比较差异无统计学意义;两组切口均为Ⅱ/甲愈合,两组均无药物不良反应发生。结论急诊剖宫产围手术期单独应用头孢硫脒预防术后感染安全有效。

OBJECTIVE To investigate the clinical efficacy and safety of cefathiamidine prophylactic application on the emergency cesarean section,so as to provide reference for rational drug usage in clinic.METHODS A total of 170cases of emergency cesarean section were randomly divided into cefathiamidine group（A,80cases）and cefoxitin group（B,90cases）.A group：30min before skin incision after anesthesia and within 4hafter the operation, cefathiamidine 2.0g＋saline 250ml was given each time by rapidly intravenous infusion,on the first day after surgery,intravenous infusion of cefathiamidine 2.0g＋saline 250ml for 2times.Group B：the same medication and medication time during surgery and postoperative period as in A group.The relevant indexes were compared in two groups.SPSS13.0software was used for statistical analysis.The t test was used and the measurement data were expressed by mean±standard deviation.Theχ2 was used for enumeration data.RESULTS The highest temperature after surgery in group A and B were（37.51±0.40）℃ and（37.36±0.31）℃ respectively,and there were no statistical differences between them.The percentage of cases that increased white blood cell count postoperation,the white blood cell count and the percentage of neutrophils in group A on the 2nd day after surgery were 57.5%,（12.95±3.47）×109/L and（80.83±7.09）%,while in group B they were 66.7%,（14.15±4.07）× 109/L and（82.03±4.38）%,and there were no statistical differences between them.The postoperative hospital day in group A was（3.59±0.68）d,shorter than that in group B（3.64±0.49）d,and there were no statistical differences between them as well.The postoperative morbidity in group A and B were 2.5%and 2.2%respectively,and the difference was not significant.The wound healing in both groups were II/A healing and didn′t show any adverse drug reactions.CONCLUSIONPerioperative application of cefathiamidine alone to prevent infection is safe and effective in emergency cesarean section.