人工耳蜗植入术后感染的因素及其生物学特点研究

Risk factors and biological characteristics of infection after cochlear implantation

目的:分析人工耳蜗植入术后感染的因素及其生物学特点,探讨如何减少术后感染及感染后的治疗措施。方法:回顾性分析2001-07-2011-10期间我院人工耳蜗植入中心接受耳蜗植入的患者发生术后感染的情况。结果:由同一术者完成的316例人工耳蜗植入手术,术后有5例发生感染,外院术后感染转来1例,共6例,均经治疗后痊愈,其中1例术后8年因植入体电极支撑小柱等因素感染取出植入体。结论:人工耳蜗植入术后感染致病菌多为金黄色葡萄球菌、铜绿假单胞菌等。细菌生物膜的形成是人工耳蜗植入术后感染的关键环节,采用化学制剂清除细菌生物膜,能够控制人工耳蜗术后感染,特别是皮瓣感染。人工耳蜗植入术后发生感染时并不一定非要取出植入体。采用积极围手术期干预,积极治疗术后感染,及时采取有效措施,是人工耳蜗植入术后言语康复的有效保障。

Objective： To analyze the factors and biological characteristics of infection after cochlear implantation so as to control the risk factors and improve the treatment of postoperative infection. Method：A retrospective study was conducted to analyze the clinical data of 316 patients receiving cochlear implantation from July 2001 to October 2011. Result：Postoperative infection was found in five of the 316 cases and one transferred case. The six cases recovered after clinical therapy without explantation. One case underwent explantation due to recurrent men- ingitis after implantation of 8 years later. Conclusion： The pathogens of infection after cochlear implantation are staphylococcus aureus, pseudomonas aeruginosa, etc. The key infectious factor is the formation of bacterial bio- film, which can be removal by chemical agents to control the postoperative infection, especially the flap infection. It is not necessary to remove the artificial cochlea when the postoperative infection occurs. Positive perioperative interventions and postoperative infection control can improve the outcome of cochlear implantation.