剖宫产围术期使用抗菌药物与新生儿高胆红素血症的关系研究
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摘要
目的:探讨剖宫产围术期使用抗菌药物与新生儿高胆红素血症的关系,为降低新生儿高胆红素血症发生率提供临床参考。方法:选取264例剖宫产妇,按随机数字表法分为对照组和观察组,各132例。对照组患者仅在术后给予抗菌药物抗感染,观察组患者术前预防使用抗菌药物,术后采用同等剂量静脉滴注。比较两组患者术后最高及平均体温、白细胞(WBC)、中性粒细胞(NEUT)、并发症发生率、经济学差异。结果:两组患者术后最高及平均体温、WBC、NEUT比例、伤口感染、热病率比较,差异均无统计学意义(P>0.05);观察组用药费用、人均用药量、住院时间以及新生儿高胆红素血症的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:剖宫产围术期规范使用抗菌药物,可有效降低剖宫产术后新生儿高胆红素血症的发生率,同时降低住院费用,缩短住院时间,具有较高的经济学价值。
OBJECTIVE:To investigate the relationship between the perioperative application of antibiotics in caesarean operation and neonatal hyperbilirubinemia,and to provide reference for reducing the incidence of neonatal hyperbilirubinemia. METHODS:264 cases of cesarean section women were randomly divided into control group and observation group,with 132 cases in each group. Control group was given antibiotics after operation,and observation group was given prophylactic application of antibiotics before operation,and equivalent dose of intravenous injection after operation. Postoperative maximum and average temperature,white blood cell(WBC),neutrophils(NEUT),complications and economic index were compared between 2 groups after operation. RESULTS:There was no statistically significant difference in postoperative maximum and average temperature,WBC count,NEUT proportion,wound infection and fever rate between 2 groups(P>0.05). The costs of medication,drug dosage per capita,hospital stay and the incidence of neonatal hyperbilirubinemia in observation group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:The perioperative standard use of antibiotics in caesarean operation could effectively reduce the incidence of postoperative neonatal hyperbilirubinemia and hospitalization cost,and cut down treatment time. It also has a high economic value and worthy of promotion.
OBJECTIVE:To investigate the relationship between the perioperative application of antibiotics in caesarean operation and neonatal hyperbilirubinemia,and to provide reference for reducing the incidence of neonatal hyperbilirubinemia. METHODS:264 cases of cesarean section women were randomly divided into control group and observation group,with 132 cases in each group. Control group was given antibiotics after operation,and observation group was given prophylactic application of antibiotics before operation,and equivalent dose of intravenous injection after operation. Postoperative maximum and average temperature,white blood cell(WBC),neutrophils(NEUT),complications and economic index were compared between 2 groups after operation. RESULTS:There was no statistically significant difference in postoperative maximum and average temperature,WBC count,NEUT proportion,wound infection and fever rate between 2 groups(P>0.05). The costs of medication,drug dosage per capita,hospital stay and the incidence of neonatal hyperbilirubinemia in observation group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:The perioperative standard use of antibiotics in caesarean operation could effectively reduce the incidence of postoperative neonatal hyperbilirubinemia and hospitalization cost,and cut down treatment time. It also has a high economic value and worthy of promotion.
引文
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[15]Christine A.Avery’s diseases of the newborn[M].Beijing:Sciencepress,2001:955.
[2]陈华虹.新生儿高胆红素血症的病因分析和防治探讨[J].海南医学,2011,22(14):72.
[3]蔡敏,周菊梅.剖宫产围术期使用抗生素的临床观察[J].中南药学,2010,08(1):70.
[4]陈水兰,邱林军,龚彩连.新生儿高胆红素血症发病危险因素及防治[J].中国现代医生,2010,48(32):151.
[5]张晓静,邓少嫦,梁丽笙,等.剖宫产围术期合理选用抗生素的临床研究[J].实用妇产科杂志,2010,26(2):128.
[6]唐凤英.90例婴儿高未结合胆红素血症临床病因分析及干预措施[J].重庆医学,2013,42(36):4 446.
[7]丁屹.抗生素应用时机选择对剖宫产术后感染发生的影响[J].中国妇幼保健,2012,27(23):3 587.
[8]乔雅莲.新生儿高胆红素血症267例相关因素分析[J].实用医技杂志,2008,15(15):1 970.
[9]曹芬利,盛春梅,严小媛.剖宫产术后感染的危险因素分析及护理体会[J].中华全科医学,2013,11(9):1 477.
[10]李红新,徐美玉,屠文娟,等.血清S1OOB蛋白和脑脊液胆红素水平在新生儿高未结合胆红素血症中检测的意义[J].实用儿科临床杂志,2012,27(14):1 086.
[11]沈丽华,王海宁,郭玉娜,等.162例新生儿高胆红素血症病因分析及治疗[J].国际病理科学与临床杂志,2013,33(2):132.
[12]闺晋,陈建华,邱萍,等.足月新生儿高胆红素血症的高危围生因素Logistic回归分析[J].中国优生与遗传杂志,2009,17(9):101.
[13]中华医学会儿科学分会新生儿组.全国新生儿黄疸与感染学术研讨会纪要[J].中华儿科杂志,2001,39(3):184.
[14]王丹谊,刘庆芝.286例新生儿病理性黄疸病因分析[J].广西中医学报,2010,13(1):41.
[15]Christine A.Avery’s diseases of the newborn[M].Beijing:Sciencepress,2001:955.