急性扁桃体炎引起扁桃体周围间隙感染的病原学特点与影响因素分析及预防  

Peritonsillar peripheral space infections caused by acute tonsillitis： pathogen characteristic, influencing risk factors and prevention

作　　者：余爵波[1] 程泽星[1] 庄远岭[1] 练状[1] 魏毅玲[1] 汪俊峰[1] 

机构地区：[1]扬州市第一人民医院耳鼻咽喉科,江苏省扬州225001

出　　处：《中国基层医药》2017年第8期1173-1177,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 研究急性扁桃体炎引起扁桃体周围间隙感染的病原学特点与影响因素,进而有针对性地采取相应措施减少扁桃体周围间隙感染的发生.方法 选取2012年1月至2016年9月在医院接受治疗的898例急性扁桃体炎患者临床资料进行研究,使用细菌鉴定仪对病原菌进行鉴定,用χ^2检验对单因素进行分析,再选择有差异的因素进行Logistic回归分析.结果 228例急性扁桃体炎患者并发扁桃体周围间隙感染,其中扁桃体周围蜂窝组织炎52例,扁桃体周脓肿176例,感染率为25.4％;共检出107株病原菌,排前3位的病原菌分别为金黄色葡萄球菌、草绿色链球菌,肺炎克雷伯菌分别占21.5％、19.6％、15.9％;单因素分析显示,有年龄、糖尿病、急性发作期吸咽及酗酒、疲劳、营养状况低、抗生素使用类别、教育程度、扁桃体周围炎病史、急性扁桃体炎类型及首诊时间长的患者感染率较高,差异有统计学意义（χ^2=39.851、8.818、89.041、87.266、30.417、21.499、13.472、64.548、12.223、62.871、70.749,均P〈0.05）;经logistic回归分析,年龄、急性发作期吸咽及酗酒、疲劳、首诊时间及急性扁桃体炎类型为扁桃体周围间隙感染的独立危险因素,差异有统计学意义（OR=2.873、5.311、5.876、0.290、2.244、2.369,均P〈0.05）;而营养状况及教育程度是独立保护因素,差异有统计学意义（OR=0.290、0.461,均P〈0.05）.结论 急性扁桃体炎易引起扁桃体周围间隙感染,必须引起高度重视,加强防治.其主要致病菌仍为金黄色葡萄球菌,经过对相关因素进行分析,应采取一定措施可减少扁桃体炎急性发作期间导致的扁桃体周围间隙感染.Objective To research the pathogen characteristics and influencing factors for peritonsillar peripheral space infections in acute tonsillitis patients,so as to take measure to reduce the peritonsillar peripheral space infections.Methods 898 acute tonsillitis patients who received treatment were chosen as study subjects.Bacteria analyzer was adopted to identify pathogens.Chi-square test was used to analyze the univariate factor,and logistic regression analysis was conducted to different factors.Results 228 patients were involved the complications of peritonsillar peripheral space infections（cellulitis in 52 cases or abscesses in 176 cases）,and the infection rate was 25.4%.Bacterial cultivation performed in 177 patients and positive results were detected in 107.The top three infections bacteria were Staphylococcus aureus （21.5%）,Streptococcus viridians （19.6%） and Klebsiella pneumoniae （15.9%）.Univariate factor analysis found that the history diabetes and peritonsillar peripheral space infections,age,acute phase of smoking and drinking,fatigue,nutritional status,class of antibiotic use,tonsillitis type,educational level and the long first diagnosis time were risk factors for peritonsillar peripheral space infections,and the differences were significant （χ^2 =39.851,8.818,89.041,87.266,30.417,21.499,13.472,64.548,12.223,62.871,70.749,all P 〈 0.05）.Logistic regression analysis found that acute phase of smoking and drinking,age,fatigue,tonsillitis type and the long first diagnosis time were independent risk factors for peritonsillar peripheral space infections patients with acute tonsillitis （OR =2.873,5.311,5.876,0.290,2.244,2.369,all P 〈 0.05）.Nutritional status and educational level had beneficial effect to peritonsillar infections event （OR =0.290,0.461,all P 〈 0.05）.Conclusion Acute tonsillitis is easy to cause peritonsillar peripheral space infection,it should be paid much attention and strengthened prevention.The pathogens causing peritonsillar peripheral space infections in a

关 键 词：扁桃体周围间隙 感染 病原学 影响因素 

分 类 号：R766.18[医药卫生—耳鼻咽喉科]