碘伏术前消毒阴道、术中冲洗宫腔预防急诊剖宫产术后切口感染疗效观察

目的:针对产妇急诊剖宫产碘伏术前阴道消毒以及术中冲洗宫腔对术后腹部切口、子宫感染的临床效果进行系统分析,以期为临床预防急诊剖宫产术后切口感染提供参考。方法:选取2013年3月至2016年6月在我院行急诊剖宫产术的产妇150例为研究对象;按产妇入院行急诊剖宫产时间顺序为分组依据,单纯抗生素组:50例,患者于围术期内均合理予以抗生素预防术后切口感染;碘伏组:50例,单纯抗生素组基础上+0.5%碘伏术前阴道消毒+术中冲洗宫腔;氯化钠组:50例,单纯抗生素组基础上+0.9%氯化钠溶液术中冲洗宫腔。分析三组产妇术后子宫及腹部切口感染发生率。结果:三组产妇术后平均体温、血白细胞、C反应蛋白水平比较,差异不明显(P>0.05);三组产妇术后腹部切口感染比较,差异不明显(P>0.05);但是,碘伏组产妇术后子宫感染发生率则明显低于单纯抗生素组(P<0.05),而与氯化钠组比较,差异不具统计学意义(P>0.05)。结论:针对急诊剖宫产产妇,立足预防性使用抗生素的基础之上,合理采用术前碘伏阴道消毒以及术中冲洗宫腔,可以有效预防剖宫产术后切口感染的发生率,具较高的应用价值。

Observation on the efficacy of preoperative vagina iodine lavage and intra-operative intrauterine iodine irrigation for the prevention of incisional infection after emergency cesarean section

Objectives:To analyze the clinical effect of preoperative vagina iodine lavage and intra-operative intrauterine iodine irrigation for the prevention of incisional infection after emergency cesarean section.Methods:150 cases of emergency cesarean section from March 2013 to June 2016 were taken as the study subjects.According to the time sequence of emergency cesarean section,only 50 cases were treated with antibiotics alone,50 patients in the perioperative period were treated with reasonable antibiotics + 0.5％ iodine preoperative vagina lavage and intra-operative intrauterine irrigation to prevent postoperative incision infection and 50 patients were treated with reasonable antibiotics + 0.9％ sodium chloride solution intraoperative intrauterine flushing.The incisional infection rate of uterus and abdomen in the 3 groups were analyzed.Results:There was no significant difference in the average body temperature,WBC and C-reactive protein between three groups (P ＞ 0.05).There was no significant difference between three groups in postoperative abdominal incision infection rate (P ＞ 0.05).However,the incidence of uterine infection in iodine group was significantly lower than that in control group (P ＜ 0.05),but also lower than that in sodium chloride group (P ＞ 0.05),and the difference was not significant (P ＞ 0.05).Conclusion:In the emergency cesarean section,based on the prophylactic use of antibiotics,the rational use of preoperative iodine vaginal disinfection and intraoperative washing of the uterine cavity can effectively prevent incision infection after cesarean section.Therefore,the method has high application value.