真菌感染与鼻窦炎相关性研究

发布时间：2019-01-09 07:17

【摘要】：目的观察真菌感染与鼻窦炎相关性,旨在探讨鼻窦炎发生发展原因。方法选取2013年4月-2016年3月医院鼻窦炎患者182例,其中鼻窦炎伴息肉90例设为观察A组、不伴息肉92例设为观察B组,选取同期健康体检者90例作为对照组;比较三组研究对象真菌阳性切片检出情况、真菌检出分类及分析真菌感染与鼻窦炎伴息肉、不伴息肉相关性。结果观察A组、观察B组真菌检出阳性率25.56%、20.65%高于对照组的18.89%,差异无统计学意义;观察A组真菌检出阳性率高于观察B组,差异无统计学意义;按照真菌性鼻窦炎标准,三组研究对象切片中检出真菌阳性切片59例,均为非侵袭型;其中三组研究对象真菌检出曲霉菌占89.83%,高于毛霉菌的3.39%、白念珠菌的6.78%,差异有统计学意义(P0.05);但三组研究对象曲霉菌构成比较,差异无统计学意义;真菌感染与鼻窦炎伴息肉发生、不伴息肉发生无明显相关性。结论真菌感染与鼻窦炎伴(或不伴)鼻息肉无明显相关性,但不可否认鼻窦炎伴(或不伴)鼻息肉者真菌感染的存在,所以手术治疗时彻底清除鼻窦腔内全部真菌团块等内容物,充分开放窦腔、改善引流,最大限度保留窦腔正常黏膜、重建与确保术后长期自鼻窦至鼻腔的充分通气与引流,有助于改变真菌赖于生存的局部环境。
[Abstract]:Objective to investigate the relationship between fungal infection and sinusitis. Methods 182 patients with sinusitis in hospital from April 2013 to March 2016 were selected. 90 patients with sinusitis and polyps were selected as observation group, 92 patients without polyps as observation group, 90 healthy persons as control group. The fungal positive sections were compared among the three groups. The fungi detection was classified and analyzed. The correlation between fungal infection and nasal sinusitis with polyp was not found. Results the positive rate of fungi detection in group A was 25.56% and 20.65% higher than that in control group (18.89%), but the positive rate of fungi in group A was higher than that in group B (no significant difference). According to the criteria of fungal sinusitis, 59 cases of fungal positive sections were found in the sections of the three groups, all of which were noninvasive. Aspergillus accounted for 89.83% in three groups, higher than 3.39% in Mucor and 6.78% in Candida albicans, the difference was statistically significant (P0.05). But there was no significant difference in the composition of Aspergillus among the three groups. There was no significant correlation between fungal infection and sinusitis associated with polyps without polyps. Conclusion there is no significant correlation between fungal infection and nasal polyps with or without sinusitis, but there is no denying the presence of fungal infection in sinusitis with or without nasal polyps. Therefore, during surgical treatment, we thoroughly cleared all the fungal lumps in the nasal sinuses, fully opened the sinus cavity, improved the drainage, maximized the preservation of the normal mucosa of the sinus cavity, and reconstructed and ensured the long-term adequate ventilation and drainage from the nasal sinus to the nasal cavity after surgery. It helps to change the local environment in which fungi depend on survival.
【作者单位】：河南省人民医院耳鼻喉科;
【基金】：河南省科技攻关基金资助项目(142102310078)
【分类号】：R765.41

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