JAMA:肥胖孕妇剖宫产后手术部位感染的预防

2017-09-20 zhangfan MedSci原创

研究发现,对于术前接受标准头孢菌素预防的肥胖剖宫产产妇,术后进行48小时的口服头孢氨苄和甲硝唑治疗可显著降低术后30天内的手术部位感染风险

统计发现美国育龄妇女的肥胖率一直在增加,而肥胖与剖宫产后手术部位感染(SSI)的危险增加相关。近日研究人员对高危人群接受剖宫产手术后最佳的围手术期抗生素预防方案进行了研究。

研究人员考察了孕前BMI大于30的女性,在接受标准静脉术前头孢菌素感染预防后,术后48小时内进行口服头孢氨苄和甲硝唑对SSI的预防效果。患者随机接受50mmg的头孢氨苄和500mg的甲硝唑(n=202)或安慰剂(n=201),每8小时一次,总计48小时。研究的主要终点是手术部位感染,包括术后30天内浅切口、深切口或器官/空间感染。

403名参与者平均年龄28岁,平均BMI 39.7,94.6%的参与者完成了研究。总的SSI率为10.9%,头孢氨苄联合甲硝唑组发生了13例术后感染,发病率为6.4%,对照组发生了31例术后感染,发病率为15.4%(差异性9.0%,相对风险0.41,[95% CI,0.22-0.77]; P=0.01)。抗生素组或安慰剂组均未发现严重不良反应,包括过敏反应在内。

研究发现,对于术前接受标准头孢菌素预防的肥胖剖宫产产妇,术后进行48小时的口服头孢氨苄和甲硝唑治疗可显著降低术后30天内的手术部位感染风险。

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    2017-09-20 Nero_L

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1971410, encodeId=6fa419e14104b, content=<a href='/topic/show?id=6af28190536' target=_blank style='color:#2F92EE;'>#肥胖孕妇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81905, encryptionId=6af28190536, topicName=肥胖孕妇)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=284b425, createdName=zll0625, createdTime=Sun Apr 15 16:01:00 CST 2018, time=2018-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1370534, encodeId=3eac13e0534b0, content=<a href='/topic/show?id=00505450e5f' target=_blank style='color:#2F92EE;'>#手术部位感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54507, encryptionId=00505450e5f, topicName=手术部位感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Fri Sep 22 01:01:00 CST 2017, time=2017-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246056, encodeId=51e024605614, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/x6JZku5ZZWUy4fKMiaEo1jFic6QIBFdyxfFI3SBY8mNNSEicqbBK991upQzicUmh7zUhHNCGzwEibBCxylLxN5o8ibjg/0, createdBy=af9c1716543, createdName=Nero_L, createdTime=Wed Sep 20 19:23:07 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245963, encodeId=b32b245963b0, content=产妇适当补充营养.合理增强体质而不是强行增肥增重.是陈旧观念下人们认知误解中亟待改变的重要内容!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/20/4297d0313cf68a34aceb111177ea7400.jpg, createdBy=2c312153996, createdName=晚晚Sachiko, createdTime=Wed Sep 20 10:20:19 CST 2017, time=2017-09-20, status=1, ipAttribution=)]
    2017-09-20 晚晚Sachiko

    产妇适当补充营养.合理增强体质而不是强行增肥增重.是陈旧观念下人们认知误解中亟待改变的重要内容!

    0

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