新疆慢性中耳炎细菌学分析及动态变化研究  

Spectrum and dynamic analysis of bacteriology in chronic otitis media in Xinjiang

作　　者：顾兴智[1,2] 尤乐都斯.克尤木 程秀琴[1] 史冬梅[1] 张华[2] 

机构地区：[1]新疆维吾尔自治区人民医院耳鼻咽喉二科,新疆乌鲁木齐830001 [2]新疆医科大学第一附属医院耳鼻咽喉科,新疆乌鲁木齐830011

出　　处：《中国耳鼻咽喉颅底外科杂志》2014年第3期223-227,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨新疆地区慢性中耳炎患者中耳分泌物的细菌学分布及动态变化。方法回顾性分析2008年1月-2013年6月我院收治的409例慢性中耳炎患者的中耳内脓性分泌物细菌培养结果,并分2008年1月-2011年12月和2012年1月-2013年6月两个时间段,对其主要致病菌分布的变化情况进行比较。结果 409例患者中检出病原菌361耳,检出率81.67%,共检出43种病原菌,位于前列的检出病原菌依次是金黄色葡萄球菌104耳（28.8%）,铜绿假单胞菌63耳（17.5%）,表皮葡萄球菌32耳（8.86%）,奇异变形杆菌22耳（6.09%）。慢性化脓性中耳炎（活动期）与中耳胆脂瘤主要病原菌构成比总体无明显差异。各种病原菌不同时间段总体构成比对比,金黄色葡萄球菌、凝固酶阴性葡萄球菌在所有致病菌中,2012-2013年度检出率比2008-2011年度检出率高。结论金黄色葡萄球菌、绿脓杆菌、表皮葡萄球菌、奇异变形杆菌是新疆慢性中耳炎主要病原菌。动态分析金黄色葡萄球菌,凝固酶阴性葡萄球菌的检出率近期有增高趋势。Objective To study the spectrum and dynamic change of bacteriology of middle ear secretions ofchronic otitis media in Xinjiang. Methods Bacterial culture results of tympanic pus from 409 patients with chronicotitis media hospitalized from Jan 2008 to June 2013 were analyzed retrospectively. The data was compared with thatfrom Jan 2008 to Dec 2011 and Jan 2012 to Jun 2013. Results Pathogenic bacteria were detected in 361specimens of 409 cases with a detective rate of 88. 26%. 43 kinds of pathogenic bacteria were detected.Staphylococcus aureus （28. 8 % ） , Pseudomonas aeruginosa （ 17. 5 % ） , Staphylococcus epidermidis （8. 86 % ） ,and Proteus mirabilis （6.09 % ） were the most frequently isolated pathogens. The distribution of pathogens in chronicotitis media was indifferent from that in cholesteatoma otitis media. Comparison of pathogenic bacteria among differentperiods showed that the detective rates of Staphylococcus aureus and coagulase-negative staphylococcus from Jan 2012to Jun 2013 were higher than those from Jan 2008 to Dec 2011. Conclusion Staphylococcus aureus, Pseudomonasaeruginosa, Epidermis staphylococcus aureus, Proteus mirabilis are the main pathogenic bacteria in chronic otitismedia in Xinjiang. By dynamic analysis, the detective rates of Staphylococcus aureus and coagulase-negativestaphylococcus have increasing tendency in chronic otitis media in recent years.

关 键 词：慢性中耳炎 病原菌 细菌学分析 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]