摘要
目的:探讨慢性鼻窦炎鼻内镜鼻窦手术(ESS)后迁延不愈者鼻窦分泌物的细菌学特征。方法:对143例慢性鼻窦炎患者行ESS,术中取筛窦分泌物做细菌培养和药物敏感试验(术前组),术后随访6个月以上,对其中未达治愈标准的49例在鼻内镜下取筛窦分泌物做细菌培养和药物敏感试验(术后组),2组结果进行比较分析。结果:术前组检出细菌153株,术后组检出细菌65株,2组均以G+球菌为主,其差异无统计学意义;术后组G-杆菌检出率显著高于术前组;而厌氧菌检出率显著低于术前组;对常用抗生素耐药的菌株比例在术后组显著高于术前组。结论:细菌感染是慢性鼻窦炎术后迁延不愈的原因之一,其致病菌仍以G+球菌为主,但G-杆菌的感染较术前增多,而厌氧菌的感染较术前减少;术后致病菌的耐药性增加。因此,对鼻内镜鼻窦手术后迁延性鼻窦炎的抗生素治疗,应建立在细菌培养和药敏试验的基础上。
Objective：To investigate the microbiology of persistent rhinosinusitis after endoscopic sinus surgery（ESS）. Method：A total of 143 patients with chronic rhinosinusitis（CRS） were selected to performed the endoscopy sinus surgery, cultures of the purulent discharges from ethmoid sinus were obtained during the operation. The patients were then followed for more than 6 months. Cultures were obtained in 49 patients who were not successfully cured 6months after surgery. Culture results were compared betweent two groups. Result： Of 143 specimens taken during the operation, 153 isolates were detected. Of 49 specimens taken from ethmoids postoperatively, 65 isolates were detected. Between two groups, there was no significant difference in the detection rate of Gram-positive coccus, and there was significant difference in the detection rate of Gram-negative rod and anaerobic bacteria. The detection rate of antibiotic-resistant organisms were significantly higher in postoperative specimens than in preoperative specimens. Conclusion：Bacteria infection is one of the etiological factors of persistent rhinosinusitis after ESS. Of the pathogenic bacteria of postoperative rhinosiusitis,Gram-positive coccus are continued to be predominant. Gram-negative rods are comparatively increased. While anaerobes are reduced. Antibiotic resistant organisms are more frequent. To treat the postoperative rhinosinusitis, obtaining a culture of the postoperative sinus cavity may therefore be important.
出处
《临床耳鼻咽喉科杂志》
CAS
CSCD
北大核心
2005年第24期1131-1133,共3页
Journal of Clinical Otorhinolaryngology
关键词
鼻窦炎
内镜术
细菌培养
微生物敏感性试验
Rhinosinusitis
Endoscopic
Bacterial cultivation
Microbial susceptibility test
