本文選題：手術(shù)　切入點(diǎn)：慢性鼻竇炎　出處：《中華醫(yī)院感染學(xué)雜志》2017年11期 　論文類型：期刊論文

【摘要】：目的探討手術(shù)對(duì)慢性鼻竇炎患者鼻腔分泌物細(xì)菌學(xué)的影響。方法選擇2014年1月-2015年12月在醫(yī)院住院治療的124例慢性鼻竇炎患者臨床資料進(jìn)行分析,所有患者采用麥塞克林格(Messerklinger)術(shù)式手術(shù),比較患者前后鼻腔分泌物細(xì)菌檢測(cè)結(jié)果。結(jié)果 124例鼻竇炎患者中105例有細(xì)菌生長(zhǎng),陽(yáng)性率84.67%,共檢出病原菌133株,其中革蘭陽(yáng)性菌90株占67.67%,革蘭陰性菌21株占15.79%,厭氧菌22株占16.54%;不同分型患者菌種分布比較差異無(wú)統(tǒng)計(jì)學(xué)意義;124例鼻竇炎患者術(shù)后好轉(zhuǎn)25例,無(wú)效17例,痊愈82例。42例術(shù)后好轉(zhuǎn)及無(wú)效患者經(jīng)復(fù)查細(xì)菌培養(yǎng),37例陽(yáng)性,陽(yáng)性率88.10%,共檢出病原菌57株,術(shù)后厭氧菌構(gòu)成比(3.51%)顯著下降,與術(shù)前(16.54%)比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后革蘭陽(yáng)性菌對(duì)青霉素、苯唑西林、環(huán)丙沙星、紅霉素等耐藥率顯著升高,與術(shù)前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后革蘭陰性菌對(duì)頭孢唑林、慶大霉素、環(huán)丙沙星的耐藥率顯著升高,與術(shù)前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論細(xì)菌感染是慢性鼻竇炎患者術(shù)后效果欠佳、遷延不愈的主要原因,術(shù)后致病菌仍然以革蘭陽(yáng)性菌為主,厭氧菌的構(gòu)成比則顯著下降,革蘭陰性菌的構(gòu)成比顯著升高。
[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.
【作者單位】： 濮陽(yáng)市油田總醫(yī)院耳鼻咽喉科;
【基金】：河南省醫(yī)學(xué)科研基金資助項(xiàng)目(A20144239)
【分類號(hào)】：R765.9

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