剖宫产术前应用抗生素预防切口感染和产褥感染的意义

摘要

目的：探讨剖宫产术前应用抗生素预防切口感染和产褥感染的意义。方法：选取2010年8月-2013年8月本院产科收治的198例剖宫产妇，按照随机数字表法将其分为对照组和观察组各99例，对照组采用术后抗生素治疗3 d，观察组采用术前抗生素治疗。观察两组切口感染和产褥感染的发生率，测定术前、术后1 d、术后3 d血浆C反应蛋白（CRP）和降钙素原（PCT）。结果：观察组切口感染率2.0%明显低于对照组的10.1%，且产褥感染率1.0%明显低于对照组的8.1%，差异均有统计学意义（P<0.01）。两组血浆CRP和PCT在术后均有明显升高，对照组术后1 d和3 d与术前比较差异均有统计学意义（P<0.01或P<0.05）；观察组术后1 d与术前比较差异有统计学意义（P<0.05），术后3 d与术前比较差异无统计学意义（P>0.05）。术后1 d，观察组血浆CRP和PCT均明显低于对照组（P<0.01）。术后3 d，观察组血浆CRP和PCT均明显低于对照组（P<0.05）。结论：术前预防应用抗生素可以明显降低剖宫产术后切口感染和产褥感染的发生，值得在临床上推广。%Objective:To investigate the significance of cesarean section incision antibiotics to prevent infection and puerperal infection.Method:198 cesarean section women were selected in our hospital from August 2010 to August 2013, they were randomly divided into the control group and the observation group,99 cases in each group.The control group was treated with postoperative antibiotics for 3 d,the observation group was treated with preoperative antibiotics.The incidence of incision infection and puerperal infection were observed.Plasma C-reactive protein(CRP)and procalcitonin(PCT)were measured before surgery and one,three postoperative days.Result:The rate of incision infection of the observation group was 2.0%,it was significantly lower than the control group(10.1%),and the puerperal infection rate of the observation group was 1.0%,it was significantly lower than the control group(8.1%),the differences were statistically significant(P<0.01). Plasma CRP and PCT of the two groups after operation were significantly higher than the postoperative,in the control group,, after 1 d and 3 d compared with the preoperative,the differences were statistically significant(P<0.01 or P<0.05).In the observation group,postoperative 1 d compared with preoperative,the difference was statistically significant(P<0.05), but postoperative 3 d compared with preoperative,there was no statistically significant difference(P>0.05).Postoperative 1 d,the plasma CRP and PCT in the observation group were significantly lower than those in the control group(P<0.01). Postoperative 3 d,the plasma CRP and PCT in the observation group were significantly lower than those in the control group (P<0.05).Conclusion:The preoperative prophylactic use of antibiotics can significantly reduce the cesarean section incision infection and puerperal infection,it is worthy of clinical promotion.