口腔颌面部牙源性感染的菌群分布与疗效分析

Distribution of bacterial flora causing maxillofacial odontogenic infections and therapeutic effect

目的对口腔颌面部牙源性感染(OIOFR)的细菌进行检测分析,探讨中西医结合疗法对OIOFR的治疗效果。方法治疗前采用需氧和厌氧培养方法分离培养183份感染标本的细菌,随机表法将口腔颌面外科收治的183例OIOFR患者分为中药治疗组、西药治疗组、中西医结合治疗组;经过3d治疗,比较3组疗效。结果 183例OIOFR患者细菌检出489株,其中厌氧菌283株占57.9%,需氧和兼性厌氧菌206株占42.1%;检出优势细菌依次为口腔链球菌群、产黑色素厌氧菌、消化链球菌和普氏菌,分别占27.6%、13.7%、10.8%、10.65%,其次是表型葡萄球菌、CO2噬纤维素菌、放线菌属、梭杆菌属、嗜血菌属、优杆菌属及奈瑟球菌属,分别占6.7%、6.3%、6.3%、6.1%、5.0、3.9%及1.8%;中药治疗组、西药治疗组、中西医结合组痊愈率分别为39.3%、57.4%和78.7%,3组疗效差异有统计学意义(P<0.05)。结论中西医结合治疗OIOFR,标本兼治、疗程短、治疗成本低、治愈率高。

OBJECTIVE To detect and analyze the bacterial flora causing the odontogenic infections in oromaxillo-facial region（OIOFR） so as to explore the effect of Chinese and western medicine on the treatment of OIOFR.METHODS A total of 183 cases of bacterial infection specimens were isolated and cultured in aerobic and anaerobic culture methods before the treatment.Totally 183 cases OIOFR patients were divided into three groups： the Chinese medicine treatment group,the western medicine group,and the integrative treatment group.The treatment efficacies between the three groups were compared after the treatment for three days.RESULTS A total of 489 strains of bacteria were isolated from the 183 cases of OIOFR patients,including 283（57.9%） strains of anaerobic bacteria and 206（42.1%） strains of aerobic and facultative anaerobes.Streptococcus oralis（27.6%）,anaerobic bacteria which could Produce melanin（13.7%）,Peptostreptococcus（10.8%）,and Prevotella（10.65%） were the predominant species of the pathogens of OIOFR,followed by the Actinomycetes（6.3%）,Fusobacterium（6.1%）,the carbon dioxide macrophages cellulose bacteria（6.3%）,phenotype aureus（6.7%）,hemophilic bacteria（5.0%）,gifted bacteria（3.9%）,and Neisseria（1.8%）.The cure rates of the Chinese medicine treatment group,the western medicine group,and the integrative treatment group were 39.3%,57.4% and 78.7%,respectively,the difference in the clinical efficacy between the three groups was statistically significant（P0.05）.CONCLUSION The integrative medicine in treatment of OIOFR can cure both symptoms and causes,with the treatment course short,the medical cost low,and the cure rate high.