喉癌患者术后气道造瘘口分泌物中病原菌培养与药敏结果对抗菌药物使用的影响  

Influence of Pathogen Culture and Drug Sensitivity Results on Antimicrobial Medication in Postoperative Airway Fistula Secretion of Patients with Laryngeal Cancer

作　　者：彭丹[1] PENG Dan(Department of Otolaryngology,Nanyang Central Hospital,Nanyang He'nan 473000,China)

机构地区：[1]南阳市中心医院耳鼻喉科,河南南阳473000

出　　处：《抗感染药学》2021年第5期639-643,共5页Anti-infection Pharmacy

摘　　要：目的:分析喉癌患者术后气道造瘘口分泌物中病原菌培养与药敏试验结果对抗菌药物使用的影响。方法:选取2017年5月—2020年1月收治的接受手术治疗的喉癌患者74例临床资料,分析其分泌物中病原菌培养与药敏试验结果,以及抗菌药物使用情况。结果:74例患者分泌物中,其中38例患者标本呈阳性(其阳性率为51.35%)并检出病原菌38株,其革兰阳性菌14株和革兰阴性菌24株,且均具有多重耐药性;革兰阴性菌的耐药率均较高,而革兰阳性菌的耐药率相对较低;术后单用抗菌药物治疗患者30例(占40.54%),二联用药44例(占59.46%)。结论:喉癌手术患者术后感染发生率较高,感染病原菌主要为革兰阴性菌,且其存在广泛耐药,采用二联抗菌药物治疗,并结合药敏试验结果选用耐药率低、抗菌谱广的抗菌药物治疗,确保其疗效。Objective: To analyze the influence of pathogen culture and drug sensitivity test results on antibacterial medication in postoperative airway fistula secretion of patients with laryngeal cancer. Methods: The clinical data of 74 patients with laryngeal cancer who received surgical treatment from May 2017 to January 2020 were selected to analyze the results of pathogen culture and drug sensitivity test in their secretions, as well as the usage of antibacterial drugs. Results: Among the 74 patients’ secretions, 38 patients had positive samples(the positive rate was 51.35%) and 38 strains of pathogenic bacteria were detected, including 14 strains of Gram-positive bacteria and 24 strains of Gram-negative bacteria, all of which were multi-drug resistant. The drug resistance rates of Gram-negative bacteria were high, while those of Gram-positive bacteria were relatively low. After operation, 30 patients were treated with antibacterial drugs alone, accounting for 40.54%, and 44 patients were treated with dual drugs, accounting for 59.46%. Conclusion: The incidence of postoperative infection in patients with laryngeal cancer surgery was relatively high, and the infective pathogenic bacteria were mainly Gram-negative bacteria with extensive drug resistance. Therefore, two-combination antibacterial drug therapy was adopted, and antibacterial drug therapy with low drug resistance rate and wide antibacterial spectrum was selected in combination with drug sensitivity test results to ensure its curative effect.

关 键 词：喉癌 气道造瘘口 抗菌药物 感染 药敏试验 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]