剖宫产术后预防性应用不同抗生素的疗效分析

Analysis of prophylactic antibiotics for cesarean section

目的 选择较理想的剖宫产术后预防性使用的抗生素。方法 回顾性分析 12 6 6例腹膜内剖宫产产妇 ,使用不同种类抗生素的临床效果及药物不良反应等。根据使用的抗生素种类分为6组 :1组用青霉素 +氨苄青霉素 ;2组用美洛西林钠 ;3组用舒巴坦 +氨苄青霉素 ;4组用环丙沙星 ;5组用盐酸克林霉素 ;6组用头孢唑啉。结果 (1)术后体温恢复正常的时间 ,1组为 (5 4 0± 2 8 4)h、2组为 (4 8 9± 2 7 8)h、3组为 (4 9 9± 2 3 9)h、4组为 (5 8 6± 33 7)h、5组为 (5 2 5± 2 5 2 )h、6组为(6 3 1± 5 1 1)h ,其中 6组较其他组术后体温恢复时间长 ,差异有极显著性 (P <0 0 0 1)。 (2 ) 2组孕妇用药费用及产褥病率与 1组比较 ,差异均无显著性 (P >0 0 5 ) ,且药物不良反应低。结论 青霉素 +氨苄青霉素仍然是剖宫产术后预防性应用抗生素的首选方案 ,美洛西林钠值得推广使用 ,对青霉素过敏者 ,抗生素的选择有限 。

Objective To study the appropriate antibiotic for prophylactic use in cesarean section. Methods The effects and side effects of prophylatic antibiotics in 1 266 cesarean section were studied retrospectively. Six regiems were engaged: (1) Penicillin and Ampicillin; (2) Mezlocillin sodium; (3) Sulbactam and Ampicillin; (4) Ciprofloxacin; (5) Clindamycin; (6) Cefacidal. Results The duration of postoperative body temperature return to normal of 1-6 group is (54.0±28.4) hours, (48.9±27.8) hours, (49.9±23.9) hours, (58.6±33.7) hours, (52.5±25.2) hours, (63.1±51.1) hours respectively. It was longer in cefazolin group than the others. There were less puerperal morbidity and side effects of Mezlocillin. Conclusions Penicillin and Ampicillin are still the most common choices as prophylatic antibiotic in cesarean section. Mezlocillin is appropriate as well.