Green S L, Sarubbi F A, Bishop E H
Obstet Gynecol. 1978 May;51(5):569-72. doi: 10.1097/00006250-197805000-00013.
A brief perioperative course of ampicillin was recommended for high-risk patients undergoing cesarean section at our institution. High-risk patients were defined as those with two or more of the following factors: general anesthesia, obesity, hematocrit less than or equal to 30%, and labor prior to delivery. Fifteen percent of high-risk patients who received prophylactic antibiotics experienced postoperative febrile morbidity compared to 63% for the high-risk untreated group (P less than 0.001). Twenty-five percent of low-risk patients (less than 2 risk factors) developed this complication. Endometritis was the leading cause of postoperative febrile morbidity. Postoperative stay was only slightly decreased in the prophylactically treated group (5.9 vs 6.2 days). Prophylactic amplicillin given perioperatively was an effective agent in reducing post-cesarean-section febrile morbidty among high-risk patients.
在我们机构，建议对接受剖宫产的高危患者在围手术期短期使用氨苄青霉素。高危患者定义为具有以下两种或更多因素的患者：全身麻醉、肥胖、血细胞比容小于或等于30%以及分娩前临产。接受预防性抗生素治疗的高危患者中有15%发生了术后发热性疾病，而未治疗的高危组为63%（P<0.001）。低危患者（风险因素少于2个）中有25%发生了这种并发症。子宫内膜炎是术后发热性疾病的主要原因。预防性治疗组的术后住院时间仅略有缩短（5.9天对6.2天）。围手术期给予预防性氨苄青霉素是降低高危患者剖宫产术后发热性疾病的有效药物。
