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

【摘要】：目的探討手術對慢性鼻竇炎患者鼻腔分泌物細菌學的影響。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行分析,所有患者采用麥塞克林格(Messerklinger)術式手術,比較患者前后鼻腔分泌物細菌檢測結果。結果 124例鼻竇炎患者中105例有細菌生長,陽性率84.67%,共檢出病原菌133株,其中革蘭陽性菌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統(tǒng)計學意義;124例鼻竇炎患者術后好轉25例,無效17例,痊愈82例。42例術后好轉及無效患者經復查細菌培養(yǎng),37例陽性,陽性率88.10%,共檢出病原菌57株,術后厭氧菌構成比(3.51%)顯著下降,與術前(16.54%)比較,差異有統(tǒng)計學意義(P0.05);術后革蘭陽性菌對青霉素、苯唑西林、環(huán)丙沙星、紅霉素等耐藥率顯著升高,與術前比較,差異有統(tǒng)計學意義(P0.05);術后革蘭陰性菌對頭孢唑林、慶大霉素、環(huán)丙沙星的耐藥率顯著升高,與術前比較,差異有統(tǒng)計學意義(P0.05)。結論細菌感染是慢性鼻竇炎患者術后效果欠佳、遷延不愈的主要原因,術后致病菌仍然以革蘭陽性菌為主,厭氧菌的構成比則顯著下降,革蘭陰性菌的構成比顯著升高。
[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】： 濮陽市油田總醫(yī)院耳鼻咽喉科;
【基金】：河南省醫(yī)學科研基金資助項目(A20144239)
【分類號】：R765.9

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