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目的:探讨预防剖宫产感染合理应用抗菌药的方法。方法:选择1997年4月至1998年2月在我院行腹膜内剖宫产62例,随机分为术前应用抗菌药组(n=31),术后应用抗菌药组(n=31)。术前组于术前20～30分钟单次冲击性静脉滴入头孢呋肟1.5g。术后组于手术结束返回病房开始每日静脉滴入头孢呋肟750mg,Bid,停静脉输入头孢呋肟后,给予头孢呋肟酯0.25g,Tid,po,直至出院。结果:在选择性剖宫产,术后最高体温两组比较无差异(P>0.05),但退热时间术前组(1.27±1.24天)较术后组(2.00±1.05天)显著缩短(P<0.05)。在非选择性剖宫产,术后最高体温及退热时间,术前组(37.21±0.27℃;1.33±1.22天)较术后组(37.87±0.39℃;2.7±1.25天)明显降低(P<0.001),明显缩短(P<0.05)。两组中无产褥病例、产褥感染及不良反应发生。结论:剖宫产预防性应用抗菌药术前给药预防效果优于术后给药,术前给药减少输液,有利产妇活动,减少感染,有利母乳喂养。
Objective: To explore the rational use of antibacterials in preventing cesarean section infection. Methods: Sixty-two patients undergoing intraperitoneal cesarean section in our hospital from April 1997 to February 1998 were randomly divided into preoperative antibacterial group (n = 31), antimicrobial group (n = 31) . Preoperative group 20-30 minutes prior to the single impact of intravenous infusion of cefuroxime 1.5g. After the operation group returned to the ward at the end of surgery began daily intravenous cefuroxime 750mg, Bid, stop the vein input cefuroxime, cefuroxime axetil given 0.25g, Tid, po, until discharged. Results: There was no significant difference in selective caesarean section and postoperative maximum body temperature between the two groups (P> 0.05), however, the pre-fever group was significantly shorter in preoperative group (1.27 ± 1.24 days) than in postoperative group (2.00 ± 1.05 days) P <0.05). In non-selective cesarean section, postoperative maximal body temperature and antipyretic time, the preoperative group (37.21 ± 0.27 ℃; 1.33 ± 1.22 days) was significantly lower than the postoperative group (37.87 ± 0.39 ℃; 2.7 ± 1.25 days) (P <0.001), significantly shortened (P <0.05). No cases of puerperal in both groups, puerperal infection and adverse reactions occurred. Conclusion: Preoperative prophylaxis with cesarean delivery for prophylactic use of prophylactic agents is superior to postoperative administration. Preoperative administration reduces transfusion, facilitates maternal activity, reduces infection and facilitates breastfeeding.