天津医药

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抗菌药物短程预防策略控制盆腔炎产妇剖宫产手术部位感染的效果评价

宁淑敏1,国心1,郝金玉1,郝晶1,陈静1,臧凤英1,周辉1,张玉荣1,郭朝辉2,高斌1   

  1. 1. 天津市传染病医院
    2. 天津医科大学
  • 收稿日期:2011-03-09 修回日期:2011-06-22 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 高斌

The Evaluation of Surgical Site Infection Prevention by Short-term Antibiotic Prophylaxis Strategy for Cesarean Section on patients with Pelvic Inflammatory Disease

  • Received:2011-03-09 Revised:2011-06-22 Published:2011-10-15 Online:2011-10-15
  • Contact: Binn GAO

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摘要： 摘要：目的 探讨围手术期短程抗菌药物使用策略预防盆腔炎产妇剖宫产后手术部位感染的效果评价。方法 选择2009年12月～2011年2月期间我院全部接受剖宫产的存在盆腔炎孕妇出院病例，随机分设头孢唑啉或联合甲硝唑短程（小于24小时）预防用药组109例和长程（大于48小时）预防用药组118例。对两组手术部位感染、术后子宫内膜炎、术后病率、抗菌药的费用等进行比较。结果 两组均未见手术部位感染发生，子宫内膜炎、术后病率、血象升高、新生儿评分、新生儿感染等均未见统计学意义。短程与长程预防策略用于抗菌药的支出分别为15.80±10.32元和115.87±49.76元 (P =0.00)。结论 头孢唑啉或联合甲硝唑短程（小于24小时）预防术中发现盆腔炎产妇手术部位感染效果与长程用药策略（大于48小时）相当，抗菌药物费用明显下降。

关键词: 手术部位感染, 剖宫产, 盆腔炎, 短程, 抗菌药物, 预防性使用

Abstract: Abstract Objective: To evaluate effect on prevention maternal/neonatal infectious morbidity by short-term prophylactic antibiotics at cesarean section with pelvic inflammatory disease (PID). Methods: All patients with PID found during cesarean section were collected during December 2009 to February 2011. Part of Perinatal infection were surveyed and compared between short-term (<24 hours, n = 109) and long-term (>48 hours, n = 118) prophylaxis by cefazolin sole or combined with metronidazole at cord clamping. Results: Statistical significant difference had not been shown in incidence of surgical site infections (SSIs), endometritis, puerperal morbidity on pregnant women who accepted cesarean section and found PID whether antibiotics were admitted by short-term or long-term. More than 86% cost reduction was found in prophylactic antimicrobial use by short-term antibiotics prophylaxis (RMB15.80±10.32 to RMB115.87±49.76, P = 0.00). Conclusion: short-term (<24 hours) prophylaxis by cefazolin sole or combined with metronidazole at cord clamping was safe and saved strategy to prevent SSIs of cesarean delivery.

Key words: surgical site infection, cesarean sectionpelvic inflammatory disease antibiotic prophylaxisshort-term