剖宫产抗生素使用时间对超重产妇感染的影响

目的:比较剖宫产术前半小时和术后断脐带后立即予静脉点滴抗生素对于超重产妇感染的影响。方法:选取2020年5月—2021年3月收治的行剖宫产的产妇775名作为研究对象。根据体重指数（BMI）将产妇分成超重组和正常体重组。根据抗生素使用时间的不同将产妇分成术前给药组和术后给药组。术前给药组剖宫产手术前30 min行头孢唑林钠静脉给药，剂量为1 g; 术后给药组断脐带后立即行头孢唑林钠静脉给药，剂量为1 g。记录各组产妇的手术时间、术中出血量、术后住院天数，住院费用；观察各组产妇手术前后体温、白细胞（WBC）数目、中性粒细胞百分比（N%）、中性粒细胞（N）绝对数目、血红蛋白（HB）数目以及切口感染情况。结果:不同体重组产妇在手术时间、术中出血量、术后住院天数、住院费用、手术前后体温、术前WBC、术前N绝对数目、手术前后HB数目以及切口感染比率上差异均无统计学意义（均P>0.05）。正常体重产妇术前给药组N绝对数目低于术后给药组，差异有统计学意义（t=4.24，P<0.05）；超重组术前给药产妇术后WBC和N绝对数目低于术后给药组，差异具有统计学意义（t=3.11、4.78,均P<0.05）。结论:超重产妇剖宫产手术前半个小时行头孢唑林钠给药较术后给药更有效预防创口感染。

The influence of antibiotics usage timing in cesarean section on overweight pregnant women

Objective: To systematically compare the effects of intravenous antibiotics on the infection of overweight pregnant women half an hour before cesarean section and immediately after the umbilical cord disconnection. Methods: A total of 775 pregnant women undergoing cesarean section from May 2020 to March 2021 were selected as the research object. The pregnant women were divided into overweight group and normal weight group according to the maternal body mass index（BMI）.The pregnant women were divided into pre-operation group and post-operation group according to the different use time of antibiotics. In the preoperative group，cefazolin sodium was administered intravenously 30 minutes before cesarean section at a dose of 1 g. Cefazolin sodium was administered intravenously at a dose of 1g after the umbilical cord cut off in the postoperative group. The operation time，intraoperative bleeding，postoperative hospitalization days and hospitalization expenses were recorded after using different antibiotics. At the same time，the body temperature，white blood cells （WBC） count，neutrophil percentage（N%），neutrophil（N） absolute number，hemoglobin（HB） number and incision infection were observed before and after operation. Results: There was no significant difference for operation time，intraoperative blood loss，postoperative hospitalization days，hospitalization expenses，body temperature before and after the operation，WBC and N absolute number before the operation，HB number before and after operation and incision infection rate between two weight groups（all P>0.05）.N absolute number in the preoperative administration group of normal weight pregnant women was lower than that in the postoperative administration group，the difference was statistically significant（t=4.24，P<0.05）.WBC and N absolute number in the preoperative group of overweight pregnant women were lower than those of the postoperative group，the differences were statistically significant（t=3.11， 4.78，all P<0.05）. Conclusion: The administration of cefazolin half an hour before cesarean section is more effective than postoperative administration in preventing wound infection for overweight pregnant women.