摘要
目的分析和评价剖宫产围手术期预防性应用抗生素的效果。方法通过检索CBM、CNKI、WanFang Data、VIP、PubMed、Embase数据库和Cochrane图书馆对照试验中心注册库,收集1975-01月/2014-04月,国内外公开发表的关于剖宫产围手术期预防性使用抗生素的情况进行了随机或非随机对照的前瞻性研究。采用Stata 12.0软件进行Meta分析。结果最终纳入16个研究,Meta分析结果显示,术前预防性应用抗生素与断脐后应用相比较,术前组腹部切口感染、子宫内膜炎和术后总感染的发病风险较断脐组显著降低,住院时间较断脐组短,但不影响新生儿结局。结论剖宫产术前与断脐后预防性应用抗生素比较,术前组腹部切口感染、子宫内膜炎和术后总感染率的发病风险显著降低,住院时间明显缩短。
Objective To analyse and evaluate the effect of prophylactic administration of antibiotics during perioperation of cesarean section.Methods Databases from January 1975 to April 2014 of CBM,CNKI,WangFang Data,VIP,PubMed,Embase and control butter center in the Cochrane Library were searched.Published articles both at home and abroad about effect of prophylactic administration of antibiotics during perioperation of cesarean section were done prospective study using random or nonrandom trials.Analyses were conducted with STATA statistical software（version 12.0）.Results Sixteen trials were included in this Meta analysis.Preoperative administration significantly reduced the risk of wound infection（RR0.63,95%CI 0.45~0.87,Z=2.83,P〈0.05）,postpartum endometritis（RR0.61,95%CI 0.44~0.87,Z=2.77,P〈0.05）and maternal total infectious morbidities（RR0.71,95%CI 0.52~0.96,Z=2.19,P〈0.05）.The preoperative group significantly reduced the length of hospital stay（WMD-0.13,95%CI-0.25^-0.02,Z=2.25,P=0.024）,but significantly increased the postoperative highest temperature（WMD0.09,95%CI 0.007~0.172,Z=2.12,P〈0.05）.Furthermore,preoperative administration of antibiotics did not significantly affect neonatal outcomes.Conclusion The evidence suggest that antibiotic prophylaxis for cesarean delivery given before skin incision rather than after cord clamping decreases the incidence of wound infection,postpartum endometritis,maternal total infectious morbidities and the length of hospital stay remarkably.
出处
《华南国防医学杂志》
CAS
2014年第12期1232-1236,共5页
Military Medical Journal of South China
基金
广东省计生委(20110273
20133056)
广东药学院临床医学院教学改革项目(2013)
关键词
剖宫产
抗生素
META分析
Cesarean section
Antibiotics
Meta analysis
