妊娠期糖尿病患者剖宫产术后抗生素不同给药方案预防感染的疗效比较

Effect Comparison of Different Antibiotic Regimens in the Prevention Infection After Cesarean in Patients with Gestational Diabetes Mellitus

目的观察比较抗生素不同给药方案对妊娠期糖尿病患者剖宫产术后预防感染的临床疗效。方法 120例行剖宫产术的妊娠期糖尿病患者随机分成研究组及对照组各60例,在新生儿断脐后静脉滴注抗生素的基础上,研究组术后6 h再追加抗生素1次,对照组继续静脉使用抗生素预防感染至术后48 h。结果研究组和对照组的有效率分别为93.4%和96.7%,WBC<12×109/L平均天数为(3.4±1.5)d和(2.9±1.4)d,无发热及术后低热并于48 h内恢复正常的分别为58例及59例,研究组切口甲级愈合56例,乙级愈合(硬结)4例,对照组切口甲级愈合58例,乙级愈合(硬结)2例,切口均无丙级愈合,两组有效率、生理病理指标、切口愈合情况比较差异均无统计学意义(P>0.05)。结论术后经静脉追加1次抗生素的预防方案在妊娠期糖尿病患者剖宫产术后预防感染的效果与传统的术后连续使用抗生素2 d的效果相仿,且具有经济、减少细菌耐药性产生的优点,值得临床推广应用。

Objective To discuss the clinical effect of different antibiotic regimens on the prevention of infection after cesarean in patients with gestational diabetes mellitus. Methods 120 patients after cesarean operation pregnancy with gestational diabetes mellitus were randomly divided into the study group and the control group, each group was 60 cases. After neonatal umbihcal, antibiotics were infused, antibiotics were added to the study group after 6h, intravenous antibiotics was used to the control group after 48. Results The effective percentage of the study group and the control group were 93.4% and 96.7% , respectively; the average number of days WBC〈12 x 109/L were （3.4 ±1.5）days and （2.9 ± 1.4）days; there were 58 cases of normal temperature and 59 cases of normal temperature after operation. There were 56 cases of grade A healing in the study group, 4 cases of B incision healing （sclerosis）, the control group were 58 cases and 2 cases. There was no C healing between groups. The effective percentage, Physiological and pathological indicators and the incision healed were no significant differences （P〉0.05）. Conclusion In the prevention of infection after cesarean in patients with gestational diabetes mellitus, the effect of adding 1 antibiotics after the operation is similar to that of the traditional method for 2 days. It has the advantages of economy and reduce the resistance of bacteria. It is worth to be popularized and applied.