120例慢性化脓性中耳炎患者耳道分泌物病原菌及治疗效果分析

发布时间：2018-06-28 16:44

本文选题：慢性化脓性中耳炎 + 病原菌　；参考：《中华医院感染学杂志》2017年10期

【摘要】：目的探讨120例慢性化脓性中耳炎患者耳道分泌物病原菌感染及抗菌治疗效果,为慢性化脓性中耳炎治疗提供参考。方法选取医院2014年1月-2016年6月接诊的120例慢性化脓性中耳炎患者,随机分为观察组和对照组,每组各60例,对照组患者给予常规治疗,观察组患者给予联合用药治疗;通过观察记录两组患者耳道分泌物培养病原菌构成及病原菌对抗菌药物的耐药性,比较两组患者的听力恢复情况、不良反应及临床治疗效果。结果 120耳耳道分泌物标本中,118耳培养出病原菌,细菌116耳,占98.30%,其中革兰阳性菌74株,占62.71%,革兰阴性菌42株,占35.59%;真菌2耳,占1.70%;观察病原菌的耐药性情况发现,革兰阳性菌和革兰阴性菌的耐药性有所不同,革兰阳性菌中葡萄菌属较为敏感的抗菌药物有头孢唑林、红霉素及奈替米星,革兰阴性菌中铜绿假单胞菌较敏感的抗菌药物有头孢他啶、万古霉素、头孢曲松及氨苄西林,革兰阳性菌与革兰阴性菌都较为敏感的药物是庆大霉素和环丙沙星;观察组听力改善率95.00%,高于对照组(81.67%),两组比较差异有统计学意义(P0.05);观察组不良反应发生率为10.00%,明显低于对照组(23.33%),两组比较差异有统计学意义(P0.05);观察组治疗总有效率91.67%,明显高于对照组(73.33%),两组比较差异有统计学意义(P0.05)。结论慢性化脓性中耳炎的主要病原菌有金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌等,常用抗菌药种类繁多,不同病原菌耐药性不同,治疗时根据细菌培养和药敏结果用药,能够避免药物乱用,更准确安全的治疗。
[Abstract]:Objective to investigate the pathogenic infection of ear canal secretion and its antibacterial effect in 120 patients with chronic suppurative otitis media, and to provide reference for the treatment of chronic suppurative otitis media. Methods 120 patients with chronic suppurative otitis media from January 2014 to June 2016 were randomly divided into observation group (n = 60) and control group (n = 60). By observing and recording the composition of pathogenic bacteria in ear canal secretion culture and the resistance of pathogens to antimicrobial agents, the hearing recovery, adverse reactions and clinical therapeutic effects of the two groups were compared. Results pathogenic bacteria were cultured in 118 ears of 120 ears of ear canal secretions, 116 ears were bacteria (98.30%), 74 were Gram-positive bacteria (62.71%), 42 were Gram-negative bacteria (35.59%), 2 ears were fungi (1.70%). The antimicrobial resistance of Gram-positive bacteria and Gram-negative bacteria is different. The more sensitive antimicrobial agents of Gram-positive bacteria are cefazolin, erythromycin and netilmicin. The more sensitive antibiotics of Pseudomonas aeruginosa were ceftazidime, vancomycin, ceftriaxone and ampicillin, gram-positive bacteria and gram-negative bacteria were gentamicin and ciprofloxacin. The rate of hearing improvement in the observation group was 95.00, which was higher than that in the control group (81.67%), the difference between the two groups was statistically significant (P0.05), the incidence of adverse reactions in the observation group was 10.00 significantly lower than that in the control group (23.33%), the difference between the two groups was statistically significant (P0.05), and the total effective rate of treatment in the observation group was significantly lower (P0.05). 91.67, significantly higher than the control group (73.33%), there was a statistical difference between the two groups (P0.05). Conclusion the main pathogens of chronic suppurative otitis media are Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa. Treatment based on bacterial culture and drug sensitivity results, can avoid drug misuse, more accurate and safe treatment.
【作者单位】：常山县人民医院耳鼻咽喉科;衢州市人民医院耳鼻咽喉科;常山县人民医院检验科;
【基金】：浙江省医药卫生科技计划基金资助项目(2012KYA189)
【分类号】：R764.21

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