剖宫产围手术期短疗程使用抗生素的临床疗效

目的：探讨剖宫产围手术期短疗程预防感染使用抗生素的临床疗效。方法选择南京医科大学附属无锡市人民医院产科2012年6月到2014年3月行选择性剖宫产手术的孕妇100例，按照随机数字表法分试验组和对照组，每组各50例，试验组在术前30min给予头孢噻肟钠，术后断脐后24h内维持给药，对照组术后仅仅断脐后24h给予头孢噻肟钠，一直持续到患者出院，观察两组应用抗生素的效果。结果对照组术后最高体温、术后退烧时间明显的高于试验组，在两组之间的差异具有统计学意义（ t值分别为5．344、6．571，均P＜0．05）；试验组的术后发病率、手术感染率以及子宫内膜炎发生率明显的低于对照组（χ2值分别为4．332、4．891、6．658，均P＜0．05）。试验组和对照组发生消化发生道反应、药物性皮疹等不良反应间差异无统计学意义（χ2值分别为1．042、1．010，均P＞0．05），术后白细胞数和中性粒细胞数在两组间的差异无统计学意义（t值分别为2．552、1．132，均P＞0．05）。结论剖宫产围手术期短疗程使用抗生素可以明显降低体温，缩短退烧时间，同时有效预防产后的感染。

Clinical efficacy of short course of antibiotics on perioperative cesarean section

Objective To investigate the clinical efficacy of short course of antibiotics on perioperative cesarean section.Methods One hundred pregnant women undergoing selective cesarean section during the period of June 2012 to March 2014 were selected from obstetrics department of People’ s Hospital of Wuxi Affiliated Nanjing Medical University.They were divided into experimental group and control group with 50 cases in each according to random number.Cefotaxime sodium was given to the experimental group 30min before operation and maintenance dose was provided within 24h after clamping umbilical cord.The control group was provided with cefotaxime sodium 24h after clamping umbilical cord till hospital discharge.The effect of two antibiotics therapy was observed.Results In the control group the highest temperature after surgery was higher and time to remove fever was longer, and the differences were significant （ t value was 5.344 and 6.571, respectively, both P 〈0.05）.Compared with the control group, the postoperative morbidity, surgical infection rate and incidence of endometritis were significantly lower in the experimental group （χ2 value was 4.332, 4.891 and 6.658, respectively, all P〈0.05）.There were no significant differences in gastrointestinal reactions and drug rash between two groups （χ2 value was 1.042 and 1.010, respectively, both P〉0.05）.The differences in postoperative leukocyte count and neutrophil count were not significant between two groups （t value was 2.552 and 1.132, respectively, both P〉0.05）.Conclusion Short course of antibiotics for perioperative cesarean section can significantly reduce body temperature and shorten fever time.Meanwhile, it can prevent postpartum infection effectively.