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目的:比较不同抗菌药物对剖宫产围术期产妇预防术后感染的临床疗效。方法:选取2015年10月—2016年10月期间收治的施行剖宫产手术产妇176例,将其分为Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组(每组44例);断脐后Ⅰ组产妇给予青霉素钠治疗,Ⅱ组产妇给予头孢唑啉治疗,Ⅲ组产妇给予头孢替安与奥硝唑联用治疗,Ⅳ组产妇不给予任何抗菌药物治疗,比较4组产妇用药后术后感染的发生率、住院时间、术中出血量和手术时间。结果:用药后4组产妇术中出血量、手术时间经组间比较其差异无统计学意义(P>0.05);Ⅰ组、Ⅱ组和Ⅲ组产妇住院时间明显短于Ⅳ组(P<0.05);Ⅰ组、Ⅱ组和Ⅲ组产妇术后感染率明显低于Ⅳ组(P<0.05)。结论:剖宫产围手术期产妇抗菌药物的预防用药应遵循“有效、经济和安全”原则;首选药物为头孢唑啉,其初始剂量应偏大,以提高血药浓度和避免细菌的耐药;对剖宫产围术期产妇应合理使用抗菌药物,熟练掌握剖宫产指征,这对提高术后抗感染具有重要意义。
OBJECTIVE: To compare the clinical effects of different antibiotics on postoperative infection prevention in perinatal period of cesarean section. Methods: A total of 176 maternal women undergoing cesarean section were selected from October 2015 to October 2016, and divided into group Ⅰ, group Ⅱ, group Ⅲ and group Ⅳ (44 cases in each group) Group maternal penicillin sodium treatment, group Ⅱ maternal cefazolin treatment, group Ⅲ maternal cefotiam and ornidazole combined treatment group Ⅳ maternal without any antimicrobial treatment, compared with the 4 groups of maternal postoperative infection The incidence of hospitalization, intraoperative blood loss and operation time. Results: There was no significant difference in bleeding volume and operation time between the four groups after operation (P> 0.05). The length of hospital stay in group Ⅰ, group Ⅱ and group Ⅲ was significantly shorter than that in group Ⅳ (P0.05 ). The postoperative infection rates of group Ⅰ, group Ⅱ and group Ⅲ were significantly lower than those of group Ⅳ (P <0.05). CONCLUSIONS: The prophylactic use of antimicrobial drugs during cesarean section during perioperative period should follow the principle of “effective, economical and safe”; the preferred drug is cefazolin, and its initial dose should be too large to increase blood concentration and avoid bacterial Drug resistance; cesarean section during perinatal maternal rational use of antimicrobial drugs, cesarean section indications, which is of great significance to improve postoperative anti-infective.