本文關(guān)鍵詞： 鼻腔灌洗液 細(xì)菌定量培養(yǎng) 急慢性鼻鼻竇炎　出處：《華中科技大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】：[目的] 通過(guò)對(duì)急慢性鼻鼻竇炎鼻腔灌洗液細(xì)菌學(xué)定量檢測(cè),尋找細(xì)菌在急慢性鼻鼻竇炎中的作用。探索鼻腔灌洗方法對(duì)鼻鼻竇炎研究的意義。 [材料和方法] ARS組病例共計(jì)10例,男女各5例,平均年齡33.9歲,病程均值7天;CRsSNP組共計(jì)29例,男19例,女10例,平均年齡26.4歲,平均病程5.3年;CRSwNP組共計(jì)20例,男13例,女7例,平均年齡42.7歲,平均病程7.9年;CONTROL組共計(jì)15例,男13例,女2例,平均年齡31.3歲。對(duì)符合條件入組病例,行雙側(cè)鼻腔灌洗,將灌洗液行細(xì)菌真菌定量檢測(cè)及藥敏試驗(yàn)。每例均行內(nèi)鏡檢查評(píng)分,同時(shí)取雙側(cè)中鼻道外側(cè)壁少量粘膜,行常見(jiàn)呼吸道病毒檢測(cè)。 [結(jié)果] 四組共分離出細(xì)菌15株,其中革蘭氏陽(yáng)性菌4株,革蘭氏陰性菌11株;真菌分離出兩株,未檢測(cè)到厭氧菌。對(duì)照組細(xì)菌陽(yáng)性率86.67%,ARS組80.00%,CRSsNP組81.48%,CRSwNP組87.50%,組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05) ARS組共分離出菌株9種,CRSSNP組分離出菌株12種,CRSWNP組分離菌株13種,CONTROL組共分離出菌株6種。細(xì)菌譜上對(duì)照組6種細(xì)菌其他三組均含有,以10000CFU/ml為陽(yáng)性標(biāo)準(zhǔn),進(jìn)行定量分析,其他三組草綠色鏈球菌,凝固酶陰性葡萄球菌陽(yáng)性率均并不高于對(duì)照(行卡方檢驗(yàn),P0.05) [結(jié)論] 1.通過(guò)細(xì)菌定量分析,與對(duì)照組交叉的陽(yáng)性菌比較,病例組陽(yáng)性率(以10000CFU/ml為陽(yáng)性標(biāo)準(zhǔn))并不高于對(duì)照組,不能說(shuō)明這些鼻腔固定菌群在病例組中是起作用的。 2.耐藥性研究上發(fā)現(xiàn)β內(nèi)酰胺酶陽(yáng)性菌株很少,僅有兩例,低于此前文獻(xiàn)報(bào)道比率。鼻腔條件致病菌對(duì)氨芐西林耐藥極為普遍,少數(shù)腸道桿菌的耐藥十分嚴(yán)重,耐藥抗生素多達(dá)10余種。 3.鼻腔灌洗液細(xì)菌培養(yǎng)不利于檢測(cè)厭氧菌,所有樣本均未檢測(cè)厭氧菌陽(yáng)性株。需氧菌檢出比率與國(guó)內(nèi)外學(xué)者研究報(bào)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.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R765

【參考文獻(xiàn)】

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1 王明明;張大良;張紅萍;王U，

本文編號(hào)：1504858