CAJ | 학술논문

目的：探讨慢性化脓性中耳炎（CSOM ）患者在乳突切除手术前、后菌群的动态变化特点。方法收集86例CSOM患者手术前、后的分泌物或组织进行细菌培养和药敏试验，对胆脂瘤组和非胆脂瘤组进行分析。结果 CSOM 患者乳突切除术前、术中、术后标本培养阳性率分别为75．6％、41．9％、1．2％；术前细菌阳性、真菌阳性、未检出致病菌在术中培养中分别有49．1％、25．0％、28．6％为细菌阳性；术中胆脂瘤组和非胆脂瘤组的培养阳性率比较差异有统计学意义（ P＜0．05）；术中取材中，脓液与组织、乳突鼓窦区与鼓窦入口区组织的细菌培养阳性率比较差异均无统计学意义（P＞0．05）；药敏情况依菌种而异。结论术中培养出的细菌及药敏试验与术前不同，胆脂瘤较非胆脂瘤患者在术中更易培养出细菌，有必要对CSOM 患者术前、术中、术后细菌培养和药敏试验进行动态监测。
목적：탐토만성화농성중이염（CSOM ）환자재유돌절제수술전、후균군적동태변화특점。방법수집86례CSOM환자수술전、후적분비물혹조직진행세균배양화약민시험，대담지류조화비담지류조진행분석。결과 CSOM 환자유돌절제술전、술중、술후표본배양양성솔분별위75．6％、41．9％、1．2％；술전세균양성、진균양성、미검출치병균재술중배양중분별유49．1％、25．0％、28．6％위세균양성；술중담지류조화비담지류조적배양양성솔비교차이유통계학의의（ P＜0．05）；술중취재중，농액여조직、유돌고두구여고두입구구조직적세균배양양성솔비교차이균무통계학의의（P＞0．05）；약민정황의균충이이。결론술중배양출적세균급약민시험여술전불동，담지류교비담지류환자재술중경역배양출세균，유필요대CSOM 환자술전、술중、술후세균배양화약민시험진행동태감측。
Objective To assess the dynamic changes of bacteria culture of patients with chronic suppurative otitis media (CSOM ) preoperative ,intraoperative ,and postoperative the mastoidectomy .Methods Secretions or tissues in 86 CSOM patients were collected for bacterial culture and drug sensitivity tests ,and analyzed the rusults between cholesteatoma group and nonchol-esteatoma group .Results Hospitalized CSOM patients with positive culture rates preoperatively ,intraoperatively and postopera-tively were 75 .6% ,41 .9% and 1 .2% respectively ;Before the mastoidectomy ,positive bacteria ,positive fungus and no pathogenic bacteria were found correspondingly 49 .1% ,25 .0% and 28 .6% of positive bacteria during the surgery .Culture positive rates be-tween the cholesteatoma group and noncholesteatoma group were significantly different intraoperatively (P<0 .05);while during in-traoperative samples ,no significant differences of positive rates were found between pyogenic fluids and tissues ,as well as tissues of mastoid tympanic antrum area and tympanic antrum entrance area (P>0 .05) .Different bacteria showed different drug sensitivity results .Conclusion Intraoperative bacteriological results shows the different bacteria and drug sensitivity from the preoperative bacteriological results ;CSOM patients with cholesteatoma are more likely to develop bacteria ;it is necessary to carry out dynamic detection on bacterial culture and drug sensitivity tests before ,during and after the surgery .