剖宫产围手术期单剂量预防性应用抗生素的临床观察

目的探讨剖宫产围手术期单剂量预防性应用抗生素的临床效果。方法将符合纳入标准的300例择期剖宫产产妇随机分为A组、B组、C组各100例。A组于术中断脐后立即予以头孢唑林钠1g＋生理盐水100ml静脉滴注,30min内滴完,术后无感染迹象不再加药;B组于术中断脐后予以头孢唑林钠1g＋生理盐水100ml静脉滴注,术后间隔6h再以同等剂量用药1次,至术后24h停药;C组术前、术中不用药,术后予以头孢唑林钠1g＋生理盐水100ml静脉滴注,每天2次,3～5d停药。观察3组产妇术后病率、腹部切口感染率、宫腔感染率、盆腔感染率、泌尿系统感染率、呼吸系统感染率、术后3d血象升高情况。结果 A、B组术后病率、腹部切口感染率、宫腔感染率、术后3d血象升高率低于C组,差异均有统计学意义（P〈0.01）;但A组与B组比较差异无统计学意义（P〉0.05）。3组间盆腔感染率、泌尿系统感染率及呼吸系统感染率比较差异均无统计学意义（P〉0.05）。结论剖宫产围手术期单剂量预防性应用抗生素疗效肯定、疗程短、不良反应少,优于术中和术后多次用药及术后连续多日用药方案,值得临床推广应用。

Clinical observation of single dose antibiotic preventive application in the perioperation of cesarean section

Objective To explore the clinical effect of single dose antibiotic preventive application in the perioperation of cesarean section.Methods 300 cases of elective cesarean section maternity who met the inclusive standard were randomly divided into group A,group B and group C,each of 100 cases.Group A：After intraoperative interrupt umbilical,immediately intravenous infusion with 1g cefazolin sodium and 100ml physiological saline,dropping off in 30 minutes.If there were no signs of infection,we won＇t increase medicine any more.Group B：Taking the same measures as group A,after surgery interrupt umbilical,immediately intravenous infusion with 1g cefazolin sodium and 100ml physiological saline,but after six hours,supply the same dose of cefazolin sodium again,stop the medicine until 24hours after surgery.Group C：No use any medicine during the surgery,and after the surgery intravenous infusion with 1g cefazolin sodium and 100ml hysiological saline twice everyday,and stop the medicine in 3 or 5 days.The postoperative morbidity,abdominal incision infection rate,uterine infection rate,pelvic infection rate,urinary system infection rate,respiratory system infection rate and hemogram rise information in 3 days after surgery of the 3 groups were observed.Results The postoperative morbidity,abdominal incision infection rate,uterine infection rate and postoperative 3 days hemogram rise rate of Group A and B is significantly lower than those of group C,and the differences were statistically significant （P0.01）;there was no significant difference between group A and group B （P0.05）.There is no obvious discrepancy between the 3 group about pelvic infection,urinary tract infection and respiratory system infection rate （P0.05）.Conclusion The preventive application of single dose antibiotic in the perioperation of cesarean section has positive curative effect,shorter course and fewer adverse reactions,and is better than the treatment program that intraoperative and postoperative multiple medication or continuous using medicine after the surgery,which is worthy of clinical popularizing and application.