手术对慢性鼻窦炎患者鼻腔分泌物细菌学的影响

发布时间：2018-03-02 17:34

本文选题：手术　切入点：慢性鼻窦炎　出处：《中华医院感染学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨手术对慢性鼻窦炎患者鼻腔分泌物细菌学的影响。方法选择2014年1月-2015年12月在医院住院治疗的124例慢性鼻窦炎患者临床资料进行分析,所有患者采用麦塞克林格(Messerklinger)术式手术,比较患者前后鼻腔分泌物细菌检测结果。结果 124例鼻窦炎患者中105例有细菌生长,阳性率84.67%,共检出病原菌133株,其中革兰阳性菌90株占67.67%,革兰阴性菌21株占15.79%,厌氧菌22株占16.54%;不同分型患者菌种分布比较差异无统计学意义;124例鼻窦炎患者术后好转25例,无效17例,痊愈82例。42例术后好转及无效患者经复查细菌培养,37例阳性,阳性率88.10%,共检出病原菌57株,术后厌氧菌构成比(3.51%)显著下降,与术前(16.54%)比较,差异有统计学意义(P0.05);术后革兰阳性菌对青霉素、苯唑西林、环丙沙星、红霉素等耐药率显著升高,与术前比较,差异有统计学意义(P0.05);术后革兰阴性菌对头孢唑林、庆大霉素、环丙沙星的耐药率显著升高,与术前比较,差异有统计学意义(P0.05)。结论细菌感染是慢性鼻窦炎患者术后效果欠佳、迁延不愈的主要原因,术后致病菌仍然以革兰阳性菌为主,厌氧菌的构成比则显著下降,革兰阴性菌的构成比显著升高。
[Abstract]:Objective to investigate the effect of surgery on the bacteriology of nasal secretion in patients with chronic sinusitis. Methods the clinical data of 124 patients with chronic sinusitis who were hospitalized in hospital from January 2014 to December 2015 were analyzed. All the patients were operated by Messerklinger, and the results of bacterial detection in nasal secretion were compared. Results among 124 cases of sinusitis, 105 cases had bacterial growth, the positive rate was 84.67%, 133 strains of pathogenic bacteria were detected. Among them, 90 strains of Gram-positive bacteria accounted for 67.67%, 21 strains of Gram-negative bacteria accounted for 15.79% and 22 strains of anaerobic bacteria accounted for 16.54.The distribution of bacteria in 124 cases of sinusitis was not significantly different from that in 124 cases of sinusitis, 25 cases were improved after operation, and 17 cases were ineffective. The positive rate of bacterial culture was 88.10%. 57 strains of pathogenic bacteria were detected. The composition of anaerobes after operation was significantly lower than that of 3.51%, which was significantly lower than that before operation (16.54%). The resistance rate of Gram-positive bacteria to penicillin, oxacillin, ciprofloxacin and erythromycin was significantly higher than that before operation (P 0.05). The drug resistance rate of ciprofloxacin was significantly higher than that before operation (P 0.05). Conclusion bacterial infection is the main cause of chronic sinusitis. The composition ratio of anaerobic bacteria decreased significantly, and that of Gram-negative bacteria increased significantly.
【作者单位】：濮阳市油田总医院耳鼻咽喉科;
【基金】：河南省医学科研基金资助项目(A20144239)
【分类号】：R765.9

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