慢性鼻窦炎手术前后分泌物细菌学对比研究及临床意义  

The Comparative Study of Bacteriology and its Clinical Significance on the Nasal Secretions at Pre-and Post-operation in Patients with Chronic Rhinosinusitis

作　　者：李小敏[1] 樊韵平[1] 陈舒琳[2] 

机构地区：[1]广东省珠海市人民医院耳鼻咽喉科,广东519000 [2]中山大学附属第五医院耳鼻咽喉科

出　　处：《中国慢性病预防与控制》2011年第4期390-392,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：广东省医学科研基金(A2000636)

摘　　要：目的对慢性鼻窦炎手术前后细菌学特性进行对比,探讨术后复发感染的可能原因,并对慢性鼻窦炎病程中细菌作用进行研究。方法内镜引导下,对接受功能性内窥镜鼻窦外科(FESS)手术的患者作分泌物需氧菌和厌氧菌培养;并在术后随访中对有复发感染表现的患者进行再次培养,将两次培养结果进行对比。结果术前细菌培养阳性率为60%,复发患者再次进行的细菌培养阳性率为100%,两次结果对比,差异有显著性(P<0.01)。两次培养结果中,有24.14%的患者与术前感染菌株相同,有75.86%的患者表现为不同的感染菌株。术后再发感染中厌氧菌比例降低,但差异无显著性。结论 FESS术后感染多为新发菌株的感染或定殖。但在个别病例中,细菌感染可能在充分治疗后仍迁延存在。Objective To analyze the bacteriological characteristics of nasal secretions at pre- and post-operation in patients with chronic rhinosinusitis （CRS）, in order to understand the causes of recurrent infection after FESS （functional endoscopic sinus surgery） of CRS. Methods The baseline nasal isolations were taken from ethmoid sinus before the operation under nasal endoscopes （95 cases）; the repeated samples were taken from the patients with postoperative recurring sinusitis （29 cases）. Both of samples were cultured in aerobic and anaerobic condition. The results of twice cultures were compared. Results The pre- and post-operative positive rates of bacteria culture were 60% （57/95） and 100% （29/29）, respectively, the difference was significant in statistics （P〈0.005）. Compared the results of bacteria culture between pre- and post-FESS in the same patient, the rates of infection with the same and different strains were 24.14% （7/29） and 75.86 % （22/29）, respectively （P=0.005）. The frequency of anaerobic strains was decreased but insignificantly. Conclusion The postoperative recurring infection was most commonly with new colonized strains. However in individual cases, the primary infective bacteria may be persistent.

关 键 词：功能性鼻内镜外科 细菌学 感染 慢性鼻窦炎 急性鼻窦炎 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]