抗菌药物的使用时机对剖宫产产妇预后的影响

The effect of use opportunity of antimicrobial agents on the prognosis of cesarean section

目的探讨抗菌药物的使用时机对剖宫产产妇预后的影响。方法收集我院2015年1~12月剖宫产分娩产妇336例,回顾分析剖宫产产妇抗菌药物的应用情况及预后。患者分为两组,A组为观察组170例,术中钳夹脐带后和术后24 h静脉滴注头孢唑林钠,B组为对照组166例,术中钳夹脐带后和术后5 d静脉滴注头孢唑林钠,比较两组患者的发热、血液分析及CRP结果、住院天数、住院费用、术后切口愈合情况、宫腔内感染、尿路感染及产后出血情况。结果两组术后发热持续时间、血液分析及CRP结果、住院天数、术后切口甲级愈合率、宫腔内感染、尿路感染及产后出血均无显著性差异（P〉0.05）,A组住院费用显著低于B组,差异有统计学意义（P〈0.05）。结论剖宫产术中钳夹脐带后和术后24 h用药可以有效预防术后感染和产后出血,但是延长用药时间并不能增加效果,反而增加患者住院费用,值得产科医生参考借鉴,以促进抗生素的合理使用。

Objective To explore the effect of use opportunity of antimicrobial agents on the prognosis of cesarean section. Methods 336 puerpera receiving cesarean delivery in our hospital from January to December 2015 were collected. The application of antimicrobial agents in cesarean section and the prognosis were retrospectively analyzed, and they were divided into two groups. 170 cases in group A were in the observation group, and intravenous drip of cefazolin sodium was given after intraoperative clamping the umbilical cord and 24 hours after the surgery. 166 cases in group B were in the control group, intravenous drip of cefazolin sodium was given after intraoperative clamping the umbilical cord and 5 days after the surgery. The fever, blood analysis and CRP results, hospital stay, hospitalization costs,postoperative incision healing, intrauterine infection, urinary tract infection and postpartum hemorrhage were compared.Results There were no significant differences in fever duration, blood analysis, CRP results, hospitalization days, postoperative wound healing rate, intrauterine infection, urinary tract infection and postpartum hemorrhage between the two groups（P〉0.05）. The cost of hospitalization in group A was significantly lower than that in group B, and the difference was statistically significant（P〈0.05）. Conclusion Medication after clamping the umbilical cord and 24 hours after the surgery in cesarean section can be effective in preventing postoperative infection and postpartum hemorrhage. However,extension of the medication time can not increase the effect, but the hospitalization cost is increased. This is worthy of being referenced for obstetricians, so as to promote the rational use of antibiotics.