8例喉癌术后咽瘘药敏试验及保守治疗分析  

Drug susceptibility test and conservative treatment of 8 cases of pharyngeal fistula after laryngocarcinoma operation

作　　者：王建国[1] 王春华[1] 韩振强[1] 

机构地区：[1]邢台市眼科医院耳鼻咽喉科,河北邢台054001

出　　处：《中华医院感染学杂志》2011年第8期1556-1558,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院喉癌术后咽瘘细菌谱特点、药敏试验结果,为抗菌药物的应用提供依据,进一步总结保守治疗咽瘘的临床经验。方法 2006年1月-2009年12月医院86例喉切除术中发生咽瘘8例患者的细菌培养及药敏试验结果,对咽瘘的细菌谱及保守治疗措施进行分析。结果 86例喉癌喉切除术中发生咽瘘8例,咽瘘发生率为9.3%;8份标本中7份有细菌生长,阳性率87.5%,其中革兰阴性杆菌5株,占71.4%,为肺炎克雷伯菌1株、铜绿假单胞菌2株、气味沙雷菌2株;革兰阳性球菌2株,占28.6%,为链球菌属2株;各菌属均对左氧氟沙星、多黏菌素B、阿米卡星敏感,5株革兰阴性杆菌对青霉素、头孢菌素耐药;咽瘘发生时间为术后7~14 d,8例经抗感染、扩创引流、加压包扎、营养支持等保守治疗措施后,12~31 d治愈。结论敏感抗菌药物的应用是控制感染、预防咽瘘形成的关键,配合扩创引流、加压包扎、营养支持等保守治疗措施可以治愈咽瘘。OBJECTIVE To investigate the characteristics of bacterial spectrum and the results of drug sensitivity test of pharyngeal fistula after laryngocarcinoma operation in our hospital,so as to provide evidence for antibiotic use,and summarize experience of conservative treatment of pharyngeal fistula.METHODS There were 8 cases of Pharyngeal fistula after laryngocarcinoma operation from Jan 2006 to Dec 2009 in hospital.The results of bacterial culture,susceptibility test and conservative therapeutic measure of pharyngeal fistula after laryngeal cancer surgery were analyzed.RESULTS Of 8 specimens,bacteria were found in 7 cases（87.5%）.5（71.4%） cases of Gram-negative bacilli,which were 1 Klebsiella pneumoniae isolate,2 P.aeruginosa isolates and 2 Serratia odor isolates and 2（28.6%） cases of Gram-positive cocci were streptococcus.Drug susceptibility results showed that the most pathogens were sensitive to levofloxacin,bacillosporin and amikacin.5 cases of Gram-negative bacilli were resistant to penicillin and cephalosporin.The occurrence time of pharyngeal fistula varies from 7 to 14 days after operation.All cases were cured by conservative treatment such as anti-infection,debridement drainage,pressure dressing,and nutritional support in 12 to 31 days.CONCLUSIONS The key to prevent the formation of pharyngeal fistula is to apply sensitive antibiotics to control infection,combining with the conservative treatments,including debridement drainage,pressure dressing and nutritional support therapy,which can finally cure pharyngeal fistula.

关 键 词：咽瘘 喉癌 喉切除术 药敏试验 

分 类 号：R181.32[医药卫生—流行病学]