伴和不伴鼻息肉的慢性鼻-鼻窦炎患者筛窦的细菌学研究

Bacteriological research into ethmoidal cellules among sufferers with chronic rhinosinusitis with or without nasal polyps

目的探讨伴和不伴鼻息肉的慢性鼻-鼻窦炎患者筛窦的细菌学是否存在不同。方法选取行鼻窦手术的慢性鼻-鼻窦炎患者100例为研究对象,根据患者是否伴有鼻息肉分为两组,伴有鼻息肉者59例为伴息肉组,未伴有鼻息肉者41例为无息肉组,鼻内镜手术中取得前筛黏膜标本,进行病原菌培养。结果送检黏膜标本经需氧与厌氧培养共有87例分离出病原菌,阳性率为87.00%,其中伴有息肉组、无息肉组阳性率分别为86.44%、87.80%,两组比较差异无统计学意义(P>0.05);伴有息肉组需氧与厌氧菌混合感染率为86.27%,无息肉组混合感染率为83.33%,比较差异无统计学意义(P>0.05);伴有息肉组患者共检出病原菌137株,无息肉组患者共检出病原菌118株,两组感染革兰氏阳性菌、阳性菌感染分布菌株比较差异无统计学意义(P>0.05)。结论伴有及不伴有鼻息肉的慢性鼻-鼻窦炎患者前筛细菌学无明显不同,均以厌氧菌混合感染为主,细菌感染并非引起鼻息肉发生的相关机制,鼻息肉的存在对感染病原菌构成无明显影响。

Objective To explore the difference of bacteriology in ethmoidal cellules among sufferers with chronic rhinosinusitis with or without nasal polyps.Methods 100 cases with chronic rhinosinusitis undergoing paranasal sinus surgery were chosen as the subjects and were divided into nasal polyps group of 59 cases and non-polyps group of 41 cases.Anterior ethmoid mucous membrane sample was obtained during nasal endoscopic surgery to cultivate pathogenic bacteria.Results 87 inspected mucous membrane samples extracted pathogenic bacteria through aerobic and anaerobic culture with the positive rate of 87.00%, among which the positive rates of the nasal polyps group and the non-polyps group were respectively 86.44% and 87.80% ,and the comparative differences between the two groups were not of statistical significance（P〉0.05）.The mixed infection rate of aerobic and anaerobic bacteria in the nasal polyps group was 86.27%, while it was 83.33% in the non-polyps group, and the comparative differences between the two groups were not of statistical sig- nificance （P 〉 0.05）. 137 pathogenic bacteria were inspected in the nasal polyps group while 118 pathogenic bacteria were inspected in the non-polyps group, and the comparative differences between the two groups in terms of gram-positive bacterium infection and positive bacteri- um infection distributed bacterial strain were not of statistical significance（P〉0.05）.Conclusion Anterior ethmoid bacteriology in chronic rhinosinusitis sufferers with or without nasal polyps was not clearly different, mainly with mixed infection of anaerobic bacteria, bacterial in- fection may not be the related mechanism of nasal polyp occurrence, and nasal polyp shows no clear influence on pathogenic bacteria infection.