慢性根尖周炎感染根管的病原学分析及影响因素研究  

Etiological characteristics and risk factors for root canal infections in patients with chronic apical periodontitis

作　　者：黄希[1] 葛自立 刘健[1] 金燕[1] 华立[1] 张小红[1] 

机构地区：[1]苏州大学附属第一医院口腔科,江苏苏州215006

出　　处：《中华医院感染学杂志》2018年第1期114-117,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析慢性根尖周炎感染根管的病原学特点和相关因素,以指导临床抗菌药物使用并制定科学预防措施。方法选择2016年1月-2017年1月在医院口腔门诊治疗的903例患者,筛选出91例慢性根尖周炎患者,通过无菌标准纸尖采集感染根管内样本,行细菌培养、分离和鉴定,以明确病原学特点;对患者的性别、年龄、刷牙方式、刷牙时间、糖尿病、使用抗菌药物、饮食喜好、根管充填、冠修复、冠填充、既往不当口腔治疗史、龋病等情况进行单因素及多因素Logistic回归分析。结果 91例慢性根尖周炎感染根管共培养出病原菌102株,其中革兰阳性菌60株,占58.82%,主要为葡萄球菌属、粪肠球菌、微单胞菌和消化链球菌,革兰阴性菌42株,占41.18%,主要为中间普雷沃菌、牙龈卟啉单胞菌、产黑普雷沃和牙髓卟啉单胞菌;多因素Logistic回归分析显示,年龄>60岁、错误刷牙方式、刷牙时间<3min、不合理使用抗菌药物、根管充填不佳、牙冠修复不佳、牙冠充填不佳、既往有不当口腔治疗史、有龋病等为慢性根尖周炎根管感染的影响因素。结论慢性根尖周炎感染根管的病原菌以革兰阳性菌为主,患者的年龄、刷牙方式及时间、使用抗菌药物、龋病、不当口腔治疗史以及牙冠修复填充不佳等为根管感染的独立影响因素,应及早进行干预治疗。OBJECTIVE To investigate the etiological characteristics and related risk factors for root canal infections in patients with chronic apical periodontitis so as to provide scientific basis for clinical use of antibiotics.METHODS Totally 903 patients who were treated in department of stomatology in the hospital from Jan 2016 to Jan 2017 were enrolled in the study, and 91 patients with chronic apical periodontitis were screened out.The samples were collect- ed from the patients with root canal infections by using sterile standard tips so as to conduct the bacterial culture, isolation and identification, and the etiological characteristics were defined.The univariate analysis and multivariate logistic regression analysis were performed for the gender, age, teeth brushing mode, teeth brushing time, diabe; tes mel｜itus, use of antibiotics, diet preference, root canal filling, crown repair, crown filling, previous history of improper oral treatment and dental caries.RESULTS A total of 102 strains of pathogens were isolated from the 91 chronic apical periodontitis patients, of which 60 （58.82%） were gram-positive bacteria, 42 （41.18%） were gram- negative bacteria! the Staphylococcus, Fnterococcus faecalis, Microbacteria and Streptococcus digestion were dominant among the gram-positive bacteria; the middle Prevotella, Porphyromonas gingivalis, Prevotella mel- aninogenica and Porphyrornonas endodontalis were the predominant species of gram-negative bacteria.The multi- variate logistic regression analysis indicated that the risk factors for the chronic apical periodontitis included the more than 60 years of age, improper teeth brushing modes, teeth brushing time less than 3 min, unreasonable use of antibiotics, poor root canal filling, previous history of improper oral treatment, poor crown repair, poor crown filling and dental caries.CONCLUSION The gram-positive bacteria are dominant among the pathogens isolated from the patients with chronic apical periodontitis.The teeth brushing modes and time, use o

关 键 词：慢性根尖周炎 根管感染 病原学特点 

分 类 号：R378[医药卫生—病原生物学]