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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。
Objective To investigate the prophylactic use of antibiotics in cesarean section perioperative period, the dose and postoperative infection. Methods A retrospective analysis of 65 cases of elective cesarean section was divided into 3 groups according to different preventive methods: group A (perioperative group) 21 cases, metronidazole and cefotaxime sodium, for surgery In the first 30 minutes, a single intravenous injection was given, intrauterine irrigation, uterine incision and abdominal cavity indwelling were performed. In group B (operation and postoperative medication group), 24 cases were treated with metronidazole for intrauterine uterine incision and abdominal cavity Indomethacin, cefotaxime sodium 3d after surgery; C group (traditional postoperative medication group) 20 cases, after cefotaxime sodium + metronidazole systemic administration of 5d. Results The postoperative maximal body temperature and antipyretic time were significantly different among the three groups (P <0.05). There was no significant difference in postoperative morbidity, abdominal wound infection and endometritis between the three groups (P> 0.05) .0 5). There were no significant differences among the three groups in white blood cell count, gastrointestinal reaction and drug-induced rash in postoperative side effects (P> 0.05). Conclusion Elective prophylactic use of antibiotics in cesarean section during perioperative period is safe and effective. The dosage is small and the course of treatment is short, which is better than that of postoperative medication.