急慢性鼻—鼻窦炎鼻腔灌洗液微生物学研究

发布时间：2018-02-12 05:13

本文关键词： 鼻腔灌洗液细菌定量培养急慢性鼻鼻窦炎　出处：《华中科技大学》2010年硕士论文　论文类型：学位论文

【摘要】：[目的] 通过对急慢性鼻鼻窦炎鼻腔灌洗液细菌学定量检测,寻找细菌在急慢性鼻鼻窦炎中的作用。探索鼻腔灌洗方法对鼻鼻窦炎研究的意义。 [材料和方法] ARS组病例共计10例,男女各5例,平均年龄33.9岁,病程均值7天;CRsSNP组共计29例,男19例,女10例,平均年龄26.4岁,平均病程5.3年;CRSwNP组共计20例,男13例,女7例,平均年龄42.7岁,平均病程7.9年;CONTROL组共计15例,男13例,女2例,平均年龄31.3岁。对符合条件入组病例,行双侧鼻腔灌洗,将灌洗液行细菌真菌定量检测及药敏试验。每例均行内镜检查评分,同时取双侧中鼻道外侧壁少量粘膜,行常见呼吸道病毒检测。 [结果] 四组共分离出细菌15株,其中革兰氏阳性菌4株,革兰氏阴性菌11株;真菌分离出两株,未检测到厌氧菌。对照组细菌阳性率86.67%,ARS组80.00%,CRSsNP组81.48%,CRSwNP组87.50%,组间差异无统计学意义(P0.05) ARS组共分离出菌株9种,CRSSNP组分离出菌株12种,CRSWNP组分离菌株13种,CONTROL组共分离出菌株6种。细菌谱上对照组6种细菌其他三组均含有,以10000CFU/ml为阳性标准,进行定量分析,其他三组草绿色链球菌,凝固酶阴性葡萄球菌阳性率均并不高于对照(行卡方检验,P0.05) [结论] 1.通过细菌定量分析,与对照组交叉的阳性菌比较,病例组阳性率(以10000CFU/ml为阳性标准)并不高于对照组,不能说明这些鼻腔固定菌群在病例组中是起作用的。 2.耐药性研究上发现β内酰胺酶阳性菌株很少,仅有两例,低于此前文献报道比率。鼻腔条件致病菌对氨苄西林耐药极为普遍,少数肠道杆菌的耐药十分严重,耐药抗生素多达10余种。 3.鼻腔灌洗液细菌培养不利于检测厌氧菌,所有样本均未检测厌氧菌阳性株。需氧菌检出比率与国内外学者研究报道相近。
[Abstract]:[purpose]. The purpose of this study was to find out the role of bacteria in the study of acute and chronic rhinosinusitis, and to explore the significance of nasal lavage in the study of rhinosinusitis by quantitative detection of bacteriology in nasal lavage fluid of acute and chronic rhinosinusitis. [materials and methods]. In the ARS group, there were 10 cases (5 male and 5 male) with an average age of 33.9 years. The mean course of disease was 7 days. There were 29 cases (male 19, female 10, mean age 26.4). The mean course of disease was 5.3 years in CRSwNP group (20 cases, 13 males, 7 females). The mean age was 42.7 years, and the mean course of disease was 7.9 years. 15 patients (13 males and 2 females) with an average age of 31.3 years were treated with bilateral nasal lavage. The bacterial fungi quantitative test and drug sensitivity test were performed in the lavage fluid, each case was scored by endoscopy, and a small amount of mucous membrane was taken from the lateral wall of bilateral middle nasal canal to detect the common respiratory tract virus. [results]. A total of 15 strains of bacteria were isolated from the four groups, of which 4 were Gram-positive bacteria, 11 Gram-negative bacteria, 2 fungi were isolated, and no anaerobic bacteria were detected. The positive rate of bacteria in the control group was 86.67 and 80.00,800 in the CRSsNP group, and 87.50 in the CRSsNP group, but there was no significant difference between the two groups (P0.05). A total of 9 strains were isolated from ARS group, 12 strains were isolated from CRSWNP group, 13 strains were isolated from control group and 6 strains were isolated from control group. The other three groups of 6 kinds of bacteria in the control group were all contained on the spectrum of bacteria. The positive standard of 10 000 CFU / ml was used as the positive standard for quantitative analysis. The positive rate of coagulase-negative staphylococci in the other three groups was not higher than that in the control group (chi-square test P0.05). [conclusion]. 1. Compared with the cross positive bacteria in the control group, the positive rate of the case group (10 000 CFU / ml) was not higher than that of the control group, which could not indicate that the fixed bacteria in the nasal cavity played an important role in the case group. 2. The drug resistance of 尾 -lactamase positive strains was found to be very few, only two cases, which was lower than that reported in previous literature. The resistance to ampicillin was very common in the pathogenic bacteria of nasal cavity, and the drug resistance of a few enterobacterias was very serious. There are more than 10 resistant antibiotics. 3. Bacterial culture in nasal lavage fluid was not conducive to the detection of anaerobic bacteria, and no positive strains of anaerobic bacteria were detected in all samples. The detection rate of aerobic bacteria was similar to that reported by domestic and foreign scholars.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R765

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