摘要
目的探讨口腔颌面部肿瘤根治切除术后一期钛板植入修复患者发生感染的病原菌分布情况、血清前白蛋白的变化特点及意义。方法选取我院2014年6月至2017年6月实施口腔颌面部肿瘤根治切除术后一期钛板植入修复患者138例,根据患者手术后是否发生感染分为感染组49例、非感染组89例,采集感染组创面分泌物进行细菌分离培养并进行药敏试验,检测对比两组患者的血清前白蛋白、超敏C反应蛋白(hs-CRP)。结果感染组49例患者,分离培养出革兰阳性菌29株(59.18%)、革兰阴性细菌20株(40.82%),其中革兰阳性细菌主要为金黄色葡萄球菌14株(28.57%)、革兰阴性细菌主要为肺炎克雷伯菌8株(16.33%)、大肠埃希菌6株(12.24%);革兰阳性细菌中金黄色葡萄球菌对青霉素G耐药率为100.00%,对万古霉素、替考拉宁敏感;革兰阴性细菌中肺炎克雷伯菌、大肠埃希菌对大部分抗生素均耐药,对亚胺培南敏感;感染组患者治疗前的血清hs-CRP、前白蛋白水平显著的高于非感染组患者(P<0.05),感染组患者治疗后的血清hs-CRP、前白蛋白水平与非感染组患者差异不具有统计学意义(P>0.05)。结论口腔颌面部肿瘤根治切除术后一期钛板植入修复患者发生感染以革兰阳性细菌为主,并且会引起患者血清hs-CRP、前白蛋白水平发生显著的改变,进行病原菌分离培养及血清hs-CRP、前白蛋白水平检测能够有效指导临床治疗。
Objective To investigate the distribution of pathogenic bacteria,the changes of serum prealbumin and its significance in patients with oral and maxillofacial tumor resection after radical resection of titanium plate. Methods A total of 138 patients were treated with titanium plate implantation after radical resection of oral and maxillofacial region in our hospital from2014.06 to 2017.06,According to whether the infection occurred after operation,the patients were divided into infection group(49 cases) and non infection group(89 cases). The wound secretions of the infection group were collected and cultured and the drug sensitivity test was carried out. The serum prealbumin and the hypersensitivity C reactive protein(hs-CRP) were detected and compared between the two groups. Results A total of 49 cases of infection group were isolated and cultured 29(59.18%) Grampositive bacteria(59.18%) and 20 Gram-negative bacteria(40.82%). Gram-positive bacteria were mainly Staphylococcus aureus14(28.57%),Gram-negative bacteria were mainly Klebsiella pneumoniae 8(16.33%),Escherichia coli 6(12.24%).The resistance rate of Staphylococcus aureus to penicillin G was 100%,and it was sensitive to vancomycin and teicoplanin. Gram negative bacteria,Klebsiella pneumoniae and Escherichia coli are resistant to most antibiotics and are sensitive to imipenem. The levels of serum hs-CRP and prealbumin in the infection group before treatment were significantly higher than those in the non infection group(P<0.05),there was no significant difference in serum hs-CRP and prealbumin between the infected group and the non infected group after treatment(P>0.05). Conclusion In patients with oral and maxillofacial tumors after radical resection,the infection of the first stage of titanium plate implantation is mainly Gram-positive bacteria,and the serum levels of hs-CRP and prealbumin are significantly changed. The pathogens are isolated and cultured. And the detection of serum hs-CRP and prealbumin levels can effectively guide clinical treatment.
作者
李宏
孙吏聪
王岳森
梁仁杰
郭福君
LI Hong;SUN Shicong;WANG Yuesen;LIANG Renjie;GUO Fujun(Department of oral and maxillofacial surgery,Kaiyuan hospital,First Affiliated Hospital of Henan University of Science and Technology,Luolong,Luoyang,Henan,471000;Biological laboratory,Kaiyuan District,First Affiliated Hospital of Henan University of Science and Technology,Henan,Luoyang,Luolong,471000.)
出处
《实验与检验医学》
CAS
2019年第4期602-605,共4页
Experimental and Laboratory Medicine
关键词
口腔
颌面部
钛板植入
感染
前白蛋白
Oral cavity
Maxillofacial Region
Titanium plate implantation
Infection
Prealbumin
