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目的评价干预剖宫产围手术期预防性使用抗菌药物的临床效果。方法循证制定剖宫产围手术期抗菌药物预防性使用指南、推荐术中予以单剂一代头孢菌素;干预后前瞻性调查130例与干预前等量随机回顾调查,对两组手术部位感染、术后子宫内膜炎、术后病率、抗菌药物的费用等进行比较。结果干预前(术前0.5h给予三代头孢菌素,术后联合甲硝唑,至少48h)、干预后手术部位感染发生率均为1.54%;产褥病率分别为3.08%、2.31%;两种策略所用抗菌药物的支出分别为(179.79±51.79)元和(14.96±15.19)元(P=0.00)。结论一代头孢菌素钳夹脐带时单剂给药作为剖宫产围手术期预防性使用抗菌药物,与之前的三代头孢菌素联合甲硝唑术后长程预防策略相比,显示手术相关感染控制效果相当,抗菌药物费用显著下降。
Objective To evaluate the clinical effect of prophylactic use of antibacterials in perioperative intervention cesarean section. Methods Evidence-based perioperative cesarean section to develop guidelines for the use of antimicrobial prophylaxis recommended intraoperative single-generation cephalosporins recommended; prospective survey of 130 cases were intervened with the same amount of randomized pre-intervention survey, the two surgical site infection , Postoperative endometritis, postoperative morbidity, cost of antibacterials, etc. were compared. Results Before intervention (0.5h before giving third generation cephalosporin, combined with metronidazole postoperatively, at least 48h), the incidence of surgical site infection was 1.54% and the rate of puerperal morbidity was 3.08% and 2.31% respectively; The expenditures of antimicrobial drugs used in the strategy were (179.79 ± 51.79) yuan and (14.96 ± 15.19) yuan (P = 0.00) respectively. Conclusions The first-generation cephalosporin clamp umbilical cord as a single-dose prophylactic cesarean section during the perioperative use of antimicrobial drugs, with previous third-generation cephalosporin combined metronidazole long-term prevention strategy compared to surgery-related infection control The effect is considerable, antimicrobial costs dropped significantly.