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目的:探讨低感染风险剖宫产产妇围术期预防性应用抗生素的最佳方案。方法:选择2007年1月～2010年12月在我院妇产科行剖宫产分娩的产妇544例,回顾性分析低感染风险子宫下段横切口剖宫产产妇围术期抗生素的不同用药方案。将其分为三组,A组190例,术前30 min一次给药,术后不再使用;B组180例,术前30 min开始给药,术后继续使用2 d;C组174例,手术结束后开始给药,共5 d。抗生素应用头孢唑林钠或林可霉素,均为静脉给药。比较三组产妇术后感染、术后病率、术后体温恢复正常的时间及住院天数。结果:544例产妇术后感染、术后病率分别为0.92%(5/544)和3.68%(20/544),三组产妇剖宫产术后感染发生率比较,差异无统计学意义(P>0.05),A组和B组产妇术后体温恢复正常的时间、术后病率及术后平均住院天数均分别显著低于C组[A组为(41.9±11.6)h、1.05%(2/190)、(4.8±1.1)d;B组为(41.1±16.5)h、1.11%(2/180)、(4.7±0.9)d;C组为(70.1±19.9)h、9.20%(16/174)、(5.9±1.1)d](均P<0.01)。但A、B组之间各项指标比较,差异无统计学意义(P>0.05)。结论:低感染风险产妇剖宫产术前30 min静脉使用抗生素能显著降低术后病率的发生,术后无需重复应用抗生素预防感染。
OBJECTIVE: To investigate the best prophylactic antibiotics for cesarean section during low perinatal period with low risk of infection. Methods: From January 2007 to December 2010 in our hospital obstetrics and gynecology cesarean delivery 544 cases of maternal women, a retrospective analysis of low risk of infection in the lower uterine transverse incision cesarean section perioperative antibiotics different medication programs . They were divided into three groups. Group A (190 cases) was given once at 30 min before operation, and was discontinued after operation. Group B (180 cases) started administration 30 minutes before operation and continued for 2 days after operation. 174 cases , After the operation began to give medicine, a total of 5 d. Antibiotics cefazolin sodium or lincomycin, are intravenous. Three groups of maternal postoperative infection, postoperative morbidity, body temperature returned to normal after hospitalization and days of hospitalization were compared. Results: The postoperative infection rates of 544 maternal women were 0.92% (5/544) and 3.68% (20/544), respectively. The incidence of infection after cesarean section was no significant difference between the three groups (P <0.05). The time of postoperative body temperature recovery, postoperative morbidity and average postoperative hospital stay in group A and group B were significantly lower than those in group C [group A (41.9 ± 11.6) h and 1.05% (41.1 ± 16.5) h, 1.11% (2/180), (4.7 ± 0.9) d in group B and (70.1 ± 19.9) h and 9.20% in group C 16/174), (5.9 ± 1.1) d] (all P <0.01). However, there was no significant difference between A and B groups (P> 0.05). CONCLUSION: Intravenous antibiotics 30 min before cesarean section at low risk of infection can significantly reduce the incidence of postoperative morbidity. No repeated antibiotics are needed to prevent infection after operation.