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剖宫产中皮肤抗菌剂对比随机临床试验
A Randomized Trial Comparing Skin Antiseptic Agents at Cesarean Delivery


Methodius G. Tuuli ... 其他 • 2016.02.18

摘要


背景

术前皮肤消毒有降低手术部位感染风险的潜力。但是,指导剖宫产中抗菌剂选择的证据有限,而该剖宫产是美国女性最常见主要手术操作。

 

方法

在此项单中心、随机、对照试验中,我们评估了氯己定-酒精术前皮肤消毒在剖宫产之后预防手术部位感染上是否优于碘酒使用。我们将接受剖宫产患者随机分配接受氯己定-酒精或碘酒皮肤消毒准备。研究主要结局为基于美国疾病预防控制中心定义的剖宫产后30天内表浅或深部手术部位感染。

 

结果

2011年9月至2015年6月,研究共纳入1,147例患者;分配572例使用氯己定-酒精,575例使用碘酒。意向治疗分析中,氯己定-酒精组23例(4%)患者诊断出手术部位感染;碘酒组为42例(7.3%)(相对危险度:0.55;95%置信区间[CI],0.34~0.90;P=0.02)。氯己定-酒精组浅表手术部位感染率为3%,碘酒组为4.9%(P=0.10);深部感染率分别为1.0%和2.4%(P=0.07)。两组不良皮肤反应发生频率相似。

 

结论

氯己定-酒精用于术前皮肤消毒与碘酒相比可显著降低剖宫产后手术部位感染风险(由国立卫生研究院和华盛顿大学圣路易斯分校医学院资助;ClinicalTrials.gov注册号,NCT01472549)。





作者信息

Methodius G. Tuuli, M.D., M.P.H., Jingxia Liu, Ph.D., Molly J. Stout, M.D., M.S.C.I., Shannon Martin, R.N., Alison G. Cahill, M.D., M.S.C.I., Anthony O. Odibo, M.D., M.S.C.E., Graham A. Colditz, M.D., Dr.P.H., and George A. Macones, M.D., M.S.C.E.
From the Department of Obstetrics and Gynecology (M.G.T., M.J.S., S.M., A.G.C., G.A.M.) and the Division of Public Health Sciences (J.L., G.A.C.), Washington University School of Medicine in St. Louis, St. Louis; and the Department of Obstetrics and Gynecology, University of South Florida, Tampa (A.O.O.). Address reprint requests to Dr. Tuuli at the Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, 4566 Scott Ave., Campus Box 8064, St. Louis, MO 63110, or at tuulim@wudosis.wustl.edu.

 

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