剖宫产术后感染的发生与抗生素应用种类的研究

Study on Occurrence of Infection after the Cesarean Section and Application Type of Antibiotics

目的分析剖宫产术后感染的发生情况与不同种类抗生素应用效果。方法将2015年6月—2018年6月期间于该院进行剖宫产手术辅助分娩的60例患者作为研究对象,采用随机分组方法将所有对象分为A组与B组。其中A组患者均采用克林霉素进行术后抗感染治疗,B组患者采用头孢哌酮舒巴坦进行术后抗感染治疗,对比两组治疗效果、各项临床指标及用药后不良反应差异情况。结果 B组产妇手术治疗后未发生产褥病与腹部切口感染,A组经治疗后产褥病发病率为6.67%,腹部切口感染发生率为6.67%,两组上述两项指标对比B组显著更低(χ~2=6.900,6.900,P=0.009),B组子宫内膜炎发生率为3.33%,A组子宫内膜炎发生率为3.33%,两组对比差异无统计学意义(χ~2=0.000,P=1.000);B组术后最高体温(37.51±0.22)℃、术后体温恢复时间(49.21±6.73)h、术后住院时间(7.05±0.61)d,A组术后最高体温(38.36±0.21)℃、术后体温恢复时间(71.08±8.04)h、术后住院时间(8.04±0.56)d,B组上述指标水平显著优于A组(t=21.371,15.941,9.141;P=0.000);B组消化道不良反应发生率3.33%、皮疹发生率3.33%,A组消化道不良反应发生率10.00%、皮疹发生率13.33%,B组在不良反应总发生率6.67%,均显著低于A组23.33%(χ~2=10.885;P=0.001)。结论产妇经剖宫产手术治疗后易出现产褥病、腹部切口感染及子宫内膜炎;头孢哌酮舒巴坦在临床中的应用可有效预防上述感染情况的发生,且用药安全性较高,有临床推广应用价值。

Objective To analyze the occurrence of infection after the cesarean section and application type of antibiotics. Methods 60 cases of patients with cesarean section in our hospital from June 2015 to June 2018 were selected and randomly divided into two groups, the group A used the clindamycin for postoperative anti-infectious therapy, while the group B used the cefoperazone and sulbactam for postoperative anti-infectious therapy, and the treatment effect, various clinical indicators and adverse reactions after medication were compared between the two groups. Results After the operative therapy, the patients with puerperal disease and abdominal incision infection in the group B did not occur, and after treatment, the morbidity of puerperalism in the group A and incidence rate of abdominal incision infection were respectively 6.67% and 6.67%, and the indicators were obviously lower than those in the group B (χ^2=6.900,6.900,P=0.009), and the incidence rate of endometritis in the group B and in the group A was respectively 3.33% and 3.33%, and the differences were not statistically significant (χ^2=0.000, P=1.000), and the highest body temperature, postoperative body temperature recovery time, postoperative length of stay in the group B and in the group A were respectively (37.51±0.22)℃,(49.21±6.73)h,(7.05±0.61)d and (38.36±0.21)℃,(71.08±8.04)h,(8.04±0.56)d, and the indicators in the group B were obviously better than those in the group A (t=21.371, 15.941, 9.141; P=0.000); and the incidence rates of digestive tract adverse reactions and rashes in the group B and in the group A were respectively 3.33%, 3.33% and 10.00%, 13.33%, and the total incidence rate of adverse reactions in the group B was obviously lower than that in the group A (6.67% vs 23.33%)(χ^2=10.885; P=0.001). Conclusion The puerperal disease, abdominal incision infection and endometritis are easy to occur of delivery women after the cesarean section, and the clinical application of cefoperazone and sulbactam can effectively prevent the occurrence of the above infection, with higher medication safety, and it is of clinical application and promotion value.