真菌感染与鼻窦炎相关性研究  

Correlation between fungal infections and sinusitis

作　　者：史凌改[1] 王广科[1] 刘军[1] 刘飞[1] 张文奇[1] 万保罗[1] 

机构地区：[1]河南省人民医院耳鼻喉科,河南郑州450003

出　　处：《中华医院感染学杂志》2017年第13期3048-3051,共4页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(142102310078)

摘　　要：目的观察真菌感染与鼻窦炎相关性,旨在探讨鼻窦炎发生发展原因。方法选取2013年4月-2016年3月医院鼻窦炎患者182例,其中鼻窦炎伴息肉90例设为观察A组、不伴息肉92例设为观察B组,选取同期健康体检者90例作为对照组;比较三组研究对象真菌阳性切片检出情况、真菌检出分类及分析真菌感染与鼻窦炎伴息肉、不伴息肉相关性。结果观察A组、观察B组真菌检出阳性率25.56%、20.65%高于对照组的18.89%,差异无统计学意义;观察A组真菌检出阳性率高于观察B组,差异无统计学意义;按照真菌性鼻窦炎标准,三组研究对象切片中检出真菌阳性切片59例,均为非侵袭型;其中三组研究对象真菌检出曲霉菌占89.83%,高于毛霉菌的3.39%、白念珠菌的6.78%,差异有统计学意义(P<0.05);但三组研究对象曲霉菌构成比较,差异无统计学意义;真菌感染与鼻窦炎伴息肉发生、不伴息肉发生无明显相关性。结论真菌感染与鼻窦炎伴(或不伴)鼻息肉无明显相关性,但不可否认鼻窦炎伴(或不伴)鼻息肉者真菌感染的存在,所以手术治疗时彻底清除鼻窦腔内全部真菌团块等内容物,充分开放窦腔、改善引流,最大限度保留窦腔正常黏膜、重建与确保术后长期自鼻窦至鼻腔的充分通气与引流,有助于改变真菌赖于生存的局部环境。OBJECTIVE To observe the correlation between fungal infections and sinusitis so as to explore the causes of sinusitis.METHODS A total of 182 patients with sinusitis who were treated in the hospital from Apr 2013 to Mar 2016 were enrolled in the study,90 sinusitis patients complicated with polyps were assigned as the group A,and 92 sinusitis patients without polyps were assigned as the group B,meanwhile,90 healthy people who received physical examination were chosen as the control group.The positive rate of detection of fungi and species of isolated fungi were compared among the three groups of study objects;the correlation between the fungal infection and the sinusitis complicated with polyps or without polyps was observed.RESULTS The positive rate of detection of fungi was 25.56%in the group A,20.65%in the group B,higher than 18.89%in the control group,and there was no significant difference;the positive rate of detection of fungi of the group A was higher than that of the group B,and there was no significant difference.According to the criteria for diagnosis of fungal sinusitis,totally59 patients were tested positive for fungal slice among the three groups of study objects,all of whom were non-invasive.Of the fungi isolated from the three groups of study objects,89.83% were Aspergillus,3.39% were Mucor,and 6.78% were Candida albicans,the differencs was significantly（P〈0.05）;however,there was no significant difference in the constituent ratio of Aspergillus among the three groups of study objects.The fungal infection was not remarkably associated with the sinusitis complicated with polyps or without polyps.CONCLUSION The fungal infection is not remarkably associated with the sinusitis complicated with（or without）polyps,however,it is undeniable that the fungal infection is prevalent among the sinusitis patients complicated with（or without）polyps.It is necessary to thoroughly remove the contents in the sinus cavity such as fungal clumps during surgical treatment,fully open the sinus cavity,improve dr

关 键 词：鼻窦炎 鼻息肉 真菌 感染 

分 类 号：R379[医药卫生—病原生物学]