剖宫产术中应用头孢类抗生素对生殖道菌群的影响

探讨择期剖宫产术中应用头孢类抗生素对生殖道菌群的影响。方法将４５例择期剖宫产者随机分为３组：Ａ组１５例，手术前、后均不应用任何抗生素；Ｂ组１５例，术后常规应用头孢类抗生素３ｄ；Ｃ组１５例，术中一次性应用头孢类抗生素。每例分别在术前、术后行阴道液、宫腔液细菌培养，，观察手术前、后生殖道菌群变化和术前，后生殖道菌群变化和术后感染情况。结果患者术前生殖道细菌培养的阳性率为３５．７１％，术后为６４．２９％

Effects of Elective Cesarean Section and Antibiotics to the Bacterial Flora in Female Genital Tract

Objective To study the effects of elective cesarean section and antibiotics to the bacterial flora in the normal female genital tract. Methods Forty-five cases of elective cesarean section were randomly divided into 3 groups: no antibiotic was given (group A), one antibiotic was given for three days (group B), and only once antibiotic was used (group C). Bacterial cultures of vaginal swab and specimens aspirated from uterine cavity were performed in each case before and after operation to supervise the changes of bacterial flora in genital tract and postoperative infection. Results The positive rate of bacterial culture was 35.71% before operation but 64.29% after operation (P<0.01). The numbers of aerobe and anaerobe were 3 and 10 strains, respectively, before operation, and 16 and 18 strains after operation. The counts of anaerobe were more than those of aerobe in group A either before or after operation in group A. The counts of aerobe, on the other hand, were more than those of anaerobe both in group B and C after operation. The rates of positive bacterial culture in uterine cavity after operation were similar among the three groups (P>0.05). Interestingly the operative infection rates were 6.67% evenly. Conclusions Both cesarean section and antibiotics may disturb the bacterial flora in the normal female genital tract. The disturbance may increase the chance for flora imbalance and the postoperative infection. There was a great need for rational application of prophylactic antibiotics after cesarean section. Singledose antibiotic during cesarean section should be advocated.