抗菌药物不同使用时间对预防剖宫产术后感染的影响

Effect of antibiotic use time for prevention of infection after cesarean section

目的观察抗菌药物不同使用时间对预防剖宫产术后感染的影响。方法选择2012年2月至2014年10月243例剖宫产产妇为研究对象,根据入院顺序随机分为A组、B组和C组,每组各81例。A组产妇在术前30 min静脉滴注抗菌药物,术后不再使用抗菌药物;B组产妇术前30 min和术后3 d连续静脉滴注抗菌药物;C组产妇仅在术后连续静脉滴注3 d抗菌药物。结果手术情况：A、B组产妇术后住院时间和住院费用均显著低于C组（t=13.603、27.024、13.367、7.939,P=0.000、0.000、0.000、0.008）,A组患者住院费用显著低于B组（t=18.019、P=0.000）;生理指标与切口愈合：A、B组产妇术后3 d最高体温、WBC计数和CRP水平均显著低于C组（t=27.322、1 333.269、21.327、16.484、119.541、17.689,P=0.000、0.000、0.000、0.000、0.000、0.000、0.000）,A组产妇WBC、CRP水平显著低于B组（t=16.037、4.557,P=0.000、0.038）;术后感染：A、B两组患者术后感染率均显著低于C组（4.94%vs 6.17%vs 17.28%）（χ^2 =4.830、6.250,P=0.032、0.026）。结论剖宫产术前30 min预防性使用抗菌药物能降低术后炎性反应及并发症发生率,促进切口愈合,缩短住院时间,节约住院费用,是一种较为理想的预防术后感染方式。

Objective To investigate the effect of antibiotic use time for prevention of infection after cesarean section. Methods Total of 243 cases of cesarean delivery mothers from February 2012 to October 2014 were divided into group A, B and C： patients in group A were given intravenous drip of antibiotics for 30 min preoperative, patients in group B were given intravenous drip of antibiotics for 30 min preoperative and for 3 d postoperative, patients in group C were given intravenous drip of antibiotics for 3 d postoperative. Results The hospital stay of were significantly shorter and hospital cost were significantly lower of patients in group A and group B compared than those of group C（t = 13.603, 27.024, 13.367 and 7.939; P = 0.000, 0.000, 0.000 and 0.008）. The hospital cost of patients in group A was significantly lower than that of group B（t = 18.019, P = 0.000）. The physiological and pathological indexes and incision healing： the highest temperature, WBC count and CRP levels of patients in group A and B were significantly lower than those of group C（t = 27.322, 1 333.269, 21.327, 16.484, 119.541 and 17.689, P = 0.000, 0.000, 0.000, 0.000, 0.000, 0.000 and 0.000）. The WBC count and levels of CRP of patients of group A were significantly lower than those of group B（t = 16.037, 4.557; P = 0.000, 0.038）. Postoperative infection： the infection rates of patients in group A and B were significantly lower than that of group C（4.94% vs 6.17% vs 17.28%）（χ^2 = 4.830, 6.250; P = 0.032, 0.026）. Conclusions Cesarean section before 30 min prophylactic use of antibiotics could reduce inflammatory reaction and complications, promote healing of incision, shorten hospitalization time and cut down the cost of hospitalization. It＇s an ideal way to prevent infection after cesarean section.