剖宫产围术期应用抗生素的临床调查

目的：了解本院剖宫产围术期预防性应用抗菌药物的现状,探讨剖宫产产妇围术期抗菌药物的合理应用的方法。方法：回顾性分析2008年1月～2010年1月妇产科200例剖宫产产妇围术期抗菌药物的使用情况。使用抗生素不超过48h和使用抗生素超过72h患者,对术后两组患者手术部位感染发生率、术后退热时间和术后住院天数、住院费用和不良反应发生率等进行比较分析。结果：200例剖宫产产妇围术期均应用了抗菌药物,使用抗菌药物不超过48h患者占28%,使用抗菌药物超过72h患者占72%,两组患者手术部位感染发生率、切口感染率、术后退热时间、术后住院天数无显著性差异（P〉0.05）,而使用抗菌药物超过72h患者的住院费用和不良反应发生率与未超过48h的患者比较有显著性差异（P〈0.01）。结论：我院剖宫产产妇围术期抗菌药物预防性应用存在应用时间过长,使用抗菌药物超过48h对患者预防术后并发症无意义而增加患者经济负担,应按围术期抗菌药物应用原则加以干预。

Investigation of perioperative antibiotics application in clinical parturients undergoing cesarean section

Objective：To investigate the preventive use of antibiotics during perioperative period in cesarean section cases in our hospital,and explore the reasonable application of antibiotics.Methods：Retrospective analysis of the perioperative using of antibiotics of 200 cases cesarean section during January 2008-January 2010.The cases were divided into two groups.Antibiotics used no more than 48 h and the other group was over 72 h.Infection rate,postoperative antifebrile time,hospitalization days,hospitalization fee and adverse reaction of the two groups were compared.Results：Antibiotics used no more than 48 h was 28 percent,while over 72 h was 72 percent.There was no significant difference on infection rate,wound infection rate,postoperative antifebrile time and hospitalization days of the patients between the two groups（P〉0.05）.Nevertheless,hospitalization fee and adverse reaction of patients in no more than 48 h group were notably low than over 72 h group（P〈0.01）.Conclusion：Our antibacterial prophylaxis application time in cesarean section puerpera perioperation is long.the preventive use of antibiotics no more than 48 h is meaningless in postoperatie complications and instead it increases economic burden of the patients.The perioperative antibacterial application should be pressed with intervention principles.