剖宫产围手术期预防性应用抗生素的临床分析

目的　探讨择期剖宫产围手术期预防性应用抗生素用药时间、剂量与术后感染的关系。方法　回顾性分析 6 5例择期剖宫产手术病人 ,根据预防性用药方法不同分为 3组 :A组 (围手术期用药组 ) 2 1例 ,选用甲硝唑与头孢噻肟钠 ,于手术前 30min内单次静脉冲击给药 ,术中冲洗宫腔、子宫切口及腹腔留置 ;B组 (手术期及术后用药组 ) 2 4例 ,术中甲硝唑冲洗宫腔、子宫切口及腹腔留置 ,术后头孢噻肟钠用药 3d ;C组 (传统术后用药组 )2 0例 ,术后头孢噻肟钠 +甲硝唑全身用药 5d。结果　术后最高体温、退热时间 3组间差异有统计学意义 (P <0 0 5 ) ;术后病率、腹部伤口感染、子宫内膜炎 3组间差异无统计学意义 (P >0 .0 5 ) ;术后副反应中白细胞计数、胃肠道反应及药物性皮疹 3组间差异无统计学意义 (P >0 .0 5 )。结论　择期剖宫产围手术期预防性使用抗生素安全、有效 ,且剂量小、疗程短 ,优于术后用药。

Clinical analysis on prophylactic application of antibiotics in peri-cesarean stage

Objective To study the relevance of medication time and dose of prophylactic application of antibiotics in peri-cesarean stage with postoperative infestation.Methods Retrospective analysis was made in 65 gravidas who received cesarotomy;these gravidas were divided into three groups according to the different medications of prophylactic drugs.Group A included 21 gravidas,who were given metronidazole and cefotaxime sodium in a single intravenous stoss medication in preoperative 30 minutes, douching the uterine cavity and uterine incision during operation,and retaining antibiotics in abdominal cavity postoperatively.Group B included 24 gravidas,who were douched in their uterine cavity and uterine incision with metronidazole and cefotaxime sodium during the surgery and given cefotaxime sodium in postoperative 3 days;Group C included 20 gravidas,who received metronidazole and cefotaxime sodium in postoperative 5 days.Results There existed significant differences in the highest postoperative temperature and pyretolytic time among the 3 groups (P<0.05).There were no significant differences in postoperative morbidity,wound infection or endometritis among the 3 groups (P>0.05);no significant differences in adverse effects,WBC counts,gastroenteric trouble or drug rash among the 3 groups (P>0.05);but significant difference of average doses of antibiotics existed among them (P<0.05).Conclusion Prophylactic application of antibiotics in peri-cesarean stage is safe, effective,with a smaller dosage and a shorter course,superior to postoperative application of antibiotics.