剖宫产术后感染的发生与抗生素应用时机的临床研究

目的对剖宫产术后感染的发生与抗生素应用时机进行研究。方法选择行剖宫产手术的269例孕妇为研究对象，分为A组89例、B组88例和C组92例。A组、B组和C组分别采用术前1．5h、术前30min和术后静脉滴注头孢唑啉钠，记录患者手术时间、术中m血量、术后体温、切口愈合情况及产褥期感染、官腔感染、泌尿系感染、白细胞升高及C反应蛋白异常发生率。结果A、B、C组孕妇手术时间（45.3±10．3）、（43．6±12．5）、（44.3±13．1）rain]及术中出血量『（131．6±19．3）、（129．1±18．7）、（128．8±22．6）mL]比较．差异均无统计学意义（P〉0．05）；而C组甲级愈合比例90．2％（83／92）1明显低于A组97．8％（87／89）1和B组97．7％（86／88）1，差异有统计学意义（P〈0．05）。C组产妇产褥感染率6．5％（6／92）1及宫内感染率7．6％（7／92）1明显高于A组f1．1％（1／89）、2．2％（2／89）]和B组【0、1．1％（1／88）]，差异均有统计学意义（P〈0．05）；C组白细胞升高及C反应蛋白异常的发生率【15．2％（14／92）]明显高于A组【4．5％（4／89）]和B组（2．3％（2／88）1，差异均有统计学意义（P〈0．05）；B组产褥感染、宫内感染及白细胞升高和C反应蛋白异常发生率与A组比较，差异无统计学意义（P〉0．05）；三组泌尿系感染发生率比较，差异无统计学意义（P〉0．05）。结论术前预防性应用抗生素对于剖宫产术后切口感染的预防有着重要的作用，术前30rain用药效果相对较佳，值得临床产科医务人员参考借鉴。

Clinical research between infection after cesarean section and the applica- tion time of antibiotics

Objective To study the infection after cesarean section and the application time of antibiotics. Methods 269 cases of pregnant women were selected and divided into in group A with 89 cases, group B with 88 cases and group C with 92 eases. Group A was treated with eefazolin sodium by intravenous drip 1.5 hours before the operation, group B was treated with cefazolin sodium by intravenous drip 30 rain before the operation, group C was treated with cefazolin sodium by intravenous drip after the operation; operation time, intraoperative blood loss, postoperative body temperature and wound healing, the incidence of puerperal infection, intrauterine infection, urinary infection, raise of white blood cells and C-reactive protein anomalies were recorded. Results The differences of operation time （45.3±10.3）, （43.6±12）, （44.3±13.1 ）mini, intraoperativc blood loss （ 131.6± 19.3 ）, （ 129.1 ± l 8.7 ）, （128.8±22.6） mL in group A, B, C were not statistically significant （P 〉 0.05）; the proportion of best grade healing in group C 90.2%（83/92）] were lower than those in group A 97.8%（87/89）] and group B 97.7%（86/88）], the differences were statistically significant （P 〈 0.05）. The incidence of puerperal infection and intrauterine infection in group C 6.5%（6/92）, 7.6%（7/92] were higher than those in group A 1.1% （1/89）, 2.2% （2/89）] and group B 0, 1.1% （1/88）], the differences were statistically significant （P 〈 0.05）; the incidence of raise of white blood cells and C-reactive protein anomalies in group C 15.2% （14/92）] was higher than that in group A 4.5%（4/89）] and group B 2.3%（2/88）], the differences were statistically significant （P 〈 0.05）; the differences of puerperal infection, intrauterine infection, raise of white blood cells and C- reactive protein anomalies in group B and group C were not statistically significant （P 〉 0.05）; the differences of urinary infection in 3 groups was not statistically significant （P 〉 0.05）. Conclusion It plays an important role in employment antibiotics before operation to prevent incision infection. Intravenous infusion of cefazolin sodium for performation in 30 min before surgery has better effect. It is worthy of references for obstetric clinical use.