剖宫产围手术期一剂抗生素应用效果观察

目的:观察剖宫产围手术期实施一剂抗生素预防用药的疗效,促进合理使用抗菌药物。方法:选择符合剖宫产指征的孕妇100例,随机分为试验组(50例)与对照组(50例)。试验组仅术中钳夹脐带后于30min内静脉滴注头孢呋辛钠1.5g1次;对照组依据《围手术期预防应用抗菌药物指南》和《剖宫产手术围手术期预防用抗菌药物管理实施细则》(征求意见稿)用药。比较2组手术持续时间、术中失血量、手术部位感染发生率、抗生素应用情况、平均住院天数、住院费用、药品费用、抗生素费用。结果:2组手术部位感染发生率比较差异无统计学意义(P>0.05);试验组均未联合用药,对照组联合应用率36%,2组比较差异有统计学意义(P<0.05);试验组无药品不良反应事件,对照组药品不良反应事件3例,2组比较差异有统计学意义(P<0.05);2组住院天数比较差异无统计学意义(P>0.05);试验组抗生素费用、药品费用、住院费用低于对照组(P<0.01)。结论:剖宫产围手术期实施一剂抗生素能预防手术部位感染,降低医疗费用。

Efficacy Observation of Perioperative Application of One Dose of Antibiotics in Cesarean Section

OBJECTIVE:To observe the therapeutic efficacy of perioperative application of one dose of antibiotics in cesarean section,and to promote rational use of antibiotics.METHODS:100 pregnant women were selected and randomly divided into trial group(50 cases) and control group(50 cases).Trial group was given intravenous drip of one dose of cefuroxime sodium1.5 g in 30 min after the ligature of the umbilical cord in the surgery;control group was given drugs according to Manual of Perioperative Prophylactic Application of Antibiotics and Rules for the Implementation of Perioperative Prophylactic Application of Antibiotics Management in Cesarean Section(Consultative Paper).The surgical duration,surgical site infection,antibiotics use,intraoperative bleeding volume,average length of stay in hospital,hospitalization expenditure,drug cost and antibiotics cost were compared between two groups after the surgery.RESULTS:There was no statistical difference in the surgical site infection(P>0.05);there was no drug combination in trial group,but 36% of drug combination was in control group,there was statistical difference(P<0.05);no adverse drug reaction had been observed in trial group,but three ADR cases had been found in control group,there was statistical difference(P<0.05);there was no statistical difference in the length of stay in hospital(P>0.05);the antibiotics cost,drug cost and the hospitalization expenditure of trial group were all lower than those of control group(P<0.01).CONCLUSION:Perioperative application of one dose of antibiotics can prevent surgical site infection and save the medical expenditure in cesarean section.