本文選題：慢性化膿性中耳炎 + 病原菌��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年10期

【摘要】：目的探討120例慢性化膿性中耳炎患者耳道分泌物病原菌感染及抗菌治療效果,為慢性化膿性中耳炎治療提供參考。方法選取醫(yī)院2014年1月-2016年6月接診的120例慢性化膿性中耳炎患者,隨機(jī)分為觀察組和對(duì)照組,每組各60例,對(duì)照組患者給予常規(guī)治療,觀察組患者給予聯(lián)合用藥治療;通過觀察記錄兩組患者耳道分泌物培養(yǎng)病原菌構(gòu)成及病原菌對(duì)抗菌藥物的耐藥性,比較兩組患者的聽力恢復(fù)情況、不良反應(yīng)及臨床治療效果。結(jié)果 120耳耳道分泌物標(biāo)本中,118耳培養(yǎng)出病原菌,細(xì)菌116耳,占98.30%,其中革蘭陽性菌74株,占62.71%,革蘭陰性菌42株,占35.59%;真菌2耳,占1.70%;觀察病原菌的耐藥性情況發(fā)現(xiàn),革蘭陽性菌和革蘭陰性菌的耐藥性有所不同,革蘭陽性菌中葡萄菌屬較為敏感的抗菌藥物有頭孢唑林、紅霉素及奈替米星,革蘭陰性菌中銅綠假單胞菌較敏感的抗菌藥物有頭孢他啶、萬古霉素、頭孢曲松及氨芐西林,革蘭陽性菌與革蘭陰性菌都較為敏感的藥物是慶大霉素和環(huán)丙沙星;觀察組聽力改善率95.00%,高于對(duì)照組(81.67%),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組不良反應(yīng)發(fā)生率為10.00%,明顯低于對(duì)照組(23.33%),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);觀察組治療總有效率91.67%,明顯高于對(duì)照組(73.33%),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論慢性化膿性中耳炎的主要病原菌有金黃色葡萄球菌、表皮葡萄球菌和銅綠假單胞菌等,常用抗菌藥種類繁多,不同病原菌耐藥性不同,治療時(shí)根據(jù)細(xì)菌培養(yǎng)和藥敏結(jié)果用藥,能夠避免藥物亂用,更準(zhǔn)確安全的治療。
[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.
【作者單位】： 常山縣人民醫(yī)院耳鼻咽喉科;衢州市人民醫(yī)院耳鼻咽喉科;常山縣人民醫(yī)院檢驗(yàn)科;
【基金】：浙江省醫(yī)藥衛(wèi)生科技計(jì)劃基金資助項(xiàng)目(2012KYA189)
【分類號(hào)】：R764.21

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本文編號(hào)：2078671