引用本文:丁明霞1,孙菊香1,罗 欣2,张雪梅2,漆洪波2.剖宫产术前和断脐后预防性应用头孢唑啉的效果比较:随机对照试验的系统回顾和Meta分析[J].重庆医科大学学报,2013,(10):1117~1120
剖宫产术前和断脐后预防性应用头孢唑啉的效果比较:随机对照试验的系统回顾和Meta分析
Comparison on effect of prophylactic administration of cefazolin prior to cesarean section and after cord clamping:a systematic review and Meta analysis of randomized controlled trials
DOI:
中文关键词:  抗生素  头孢唑啉  剖宫产  Meta分析
英文关键词:antibiotics  cefazolin  cesarean delivery  Meta analysis
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作者单位
丁明霞1,孙菊香1,罗 欣2,张雪梅2,漆洪波2 1. 山东省临沂市人民医院产科临沂 2760002. 重庆医科大学附属第一医院妇产科重庆 400016 
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中文摘要:
      目的:总结已发表的文献,分析比较剖宫产术前和断脐后应用头孢唑啉的效果。方法:通过系统性搜索数据库,包括PubMed、Embase和Cochrane图书馆的CENTRAL,进行随机对照试验,比较剖宫产术前预防性应用头孢唑啉与断脐后应用的差异。结果:对6个高质量的随机对照试验进行Meta分析。术前预防性应用头孢唑啉与断脐后应用相比较,产后子宫内膜炎的发病风险有明显的降低(RR=0.57,95%CI=0.36~0.90,P=0.02)。而伤口感染(RR=0.70,95%CI=0.43~1.12)和尿路感染发病风险(RR=1.19,95%CI=0.53~2.63)无明显差别。而且,术前应用头孢唑啉并没有明显增加新生儿败血症(RR=0.82,95%CI=0.47~1.42)、需要诊断检查而未确诊的败血症(RR=0.94,95%CI=0.72~1.22)以及新生儿转入重症监护室(RR=0.90,95%CI=0.62~1.28)的风险。结论:剖宫产术前预防性应用头孢唑啉可明显降低产后子宫内膜炎的发病率。
英文摘要:
      Objective:To summarize the published evidences and to compare effect of prophylactic administration of cefazolin prior to cesarean section and after cord clamping. Methods:Databases of PubMed,Embase,and CENTRAL in the Cochrane Library were searched for randomized controlled trials and effect of prophylactic administration of cefazolin prior to cesarean section and after cord clamping were compared. Results:Six randomized controlled trials with high quality were included in this Meta analysis. Preoperative administration significantly reduced the risk of postpartum endometritis(RR=0.57,95%CI=0.36 to 0.90,P=0.02). Preoperative admin-istration of cefazolin was not associated with significant reduction in the risk of wound infection(RR=0.70,95%CI=0.43 to 1.12) and urinary tract infection(RR=1.19,95%CI=0.53 to 2.63). Furthermore,preoperative administration of cefazolin did not significantly af-fect proven neonatal sepsis(RR=0.82,95%CI=0.47 to 1.42),suspected neonatal sepsis cases which require workup(RR=0.94,95%CI=0.72 to 1.22) and neonatal intensive care unit admissions(RR=0.90,95%CI=0.62 to 1.28). Conclusion:Prophylactic administra-tion of cefazolin prior to cesarean section can significantly decrease the incidence of postpartum endometritis.
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