计划性剖宫产中抗生素预防感染临床分析

Clinical analysis of using antibiotics to prevent infection during planned cesarean delivery

目的:探讨计划性剖宫产围手术期抗生素使用至术后24小时停药临床可实施性及安全性。方法:选取我院2013年6月至2014年1月收治的60例进入临床路径计划性剖宫产孕足月孕妇作为观察组,同期选取62例进入临床路径计划性剖宫产孕妇作为对照组,观察组在手术前一日进行药敏试验,手术当日将头孢菌素一代(注射用五水头孢唑林钠)带入手术室,当胎儿娩出断脐后立即将注射用五水头孢唑林钠2.0g溶于100ml生理盐水中静脉滴注1次,12h后再静滴1次,即停药。一共应用4.0g。对照组在术中不用药,术后开始应用注射用五水头孢唑林钠2.0g,静脉滴注频率为2次/d,一直持续到术后3-4d停药。结果:两组患者在术后体温、切口愈合、子宫复旧、产褥感染、血常规差异无统计学意义,(P>0.05),但是观察组相关治疗费用、术后住院日、药物不良反应比对照组有明显差异,具有统计学意义(P<0.05)。结论:计划性剖宫产抗生素应用至术后24小时停药,明显缩短抗生素使用时间,安全可靠、经济合理,具有较强的实施性,值得在临床上大量推广应用。

Objective：To study the possibility and safety of using antibiotics from perioperative period to 24 hours post surgery in planned cesarean delivery. Methods：Select 60 pregnant women who went clinically planned cesarean delivery from June 2013 to January 2014 as observation group, meanwhile select 62 who went clinically planned cesarean delivery as comparison group, drug sensitive test was conducted to the observation group one day before the surgery. Cephalosporin rhzomorph first generation （Cefazolin Sodium Pentahydrate for Injection）were brought to operation room on the day of surgery. After cutting of baby’s navel, inject Cefazolin Sodium Pentahydrate for Injection which dissolved in 100ml normal saline through intravenous drip. One more drip after 12hours, then stop using antibiotics, total dose 4g. No antibiotics used to the comparison group during the surgery. 2g Cefazolin Sodium Pentahydrate for Injection was used after the surgery through intravenous drip twice a day. This continued 3-4 days, then stop using antibiotics. Results：There is no statistical significance on body temperature, wound healing, involution of uterus, puerperal infection, blood routine examination between the two group of patients after surgery （P〉0.05）. However statistical significance exists on relative clinical expenses, days in hospital after surgery, adverse drug reaction between observation group and comparison group （P〈0.05）. Conclusion：the antibiotic application from perioperative period to 24 hours post surgery in planned cesarean delivery is worth of being broadly applied for the reason of shortening the time of using antibiotics. It is safe and reliable, economical and very easily executed.