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目的探讨120例慢性化脓性中耳炎患者耳道分泌物病原菌感染及抗菌治疗效果,为慢性化脓性中耳炎治疗提供参考。方法选取医院2014年1月-2016年6月接诊的120例慢性化脓性中耳炎患者,随机分为观察组和对照组,每组各60例,对照组患者给予常规治疗,观察组患者给予联合用药治疗;通过观察记录两组患者耳道分泌物培养病原菌构成及病原菌对抗菌药物的耐药性,比较两组患者的听力恢复情况、不良反应及临床治疗效果。结果 120耳耳道分泌物标本中,118耳培养出病原菌,细菌116耳,占98.30%,其中革兰阳性菌74株,占62.71%,革兰阴性菌42株,占35.59%;真菌2耳,占1.70%;观察病原菌的耐药性情况发现,革兰阳性菌和革兰阴性菌的耐药性有所不同,革兰阳性菌中葡萄菌属较为敏感的抗菌药物有头孢唑林、红霉素及奈替米星,革兰阴性菌中铜绿假单胞菌较敏感的抗菌药物有头孢他啶、万古霉素、头孢曲松及氨苄西林,革兰阳性菌与革兰阴性菌都较为敏感的药物是庆大霉素和环丙沙星;观察组听力改善率95.00%,高于对照组(81.67%),两组比较差异有统计学意义(P<0.05);观察组不良反应发生率为10.00%,明显低于对照组(23.33%),两组比较差异有统计学意义(P<0.05);观察组治疗总有效率91.67%,明显高于对照组(73.33%),两组比较差异有统计学意义(P<0.05)。结论慢性化脓性中耳炎的主要病原菌有金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌等,常用抗菌药种类繁多,不同病原菌耐药性不同,治疗时根据细菌培养和药敏结果用药,能够避免药物乱用,更准确安全的治疗。
Objective To investigate the pathogenic bacteria infection and antibacterial effect of 120 cases of chronic suppurative otitis media in patients with chronic suppurative otitis media and provide reference for the treatment of chronic suppurative otitis media. Methods A total of 120 patients with chronic suppurative otitis media admitted from January 2014 to June 2016 in our hospital were randomly divided into observation group and control group, 60 cases in each group. Patients in control group were given routine treatment and patients in observation group were given combined treatment Through the observation and recording of the pathogenic bacteria in the ear canal secretion of two groups of patients and the drug resistance of the pathogenic bacteria to the antibacterial drugs, the hearing recovery, adverse reactions and clinical effects of the two groups were compared. Results Among the 120 ear canal secretions, 116 strains of bacteria were found in 118 ears, accounting for 98.30% of the total, including 74 strains of Gram-positive bacteria, accounting for 62.71% and 42 strains of Gram-negative bacteria accounting for 35.59% , Accounting for 1.70%; observed pathogenic bacteria drug resistance found that Gram-positive bacteria and Gram-negative bacteria have different resistance, Gram-positive bacteria in the more sensitive Staphylococcus antimicrobial cefazolin, red Mycotoxin and netilmicin, Gram-negative bacteria more sensitive to Pseudomonas aeruginosa ceftazidime, vancomycin, ceftriaxone and ampicillin, Gram-positive bacteria and gram-negative bacteria are more sensitive Drugs were gentamicin and ciprofloxacin; observation group hearing improvement rate was 95.00%, higher than the control group (81.67%), the difference between the two groups was statistically significant (P <0.05); the incidence of adverse reactions in the observation group was (P <0.05). The total effective rate of the observation group was 91.67%, which was significantly higher than that of the control group (73.33%), the difference between the two groups was statistically significant There was statistical significance (P <0.05). Conclusion The main pathogens of chronic suppurative otitis media are Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa, etc. There are many kinds of antibacterials commonly used and different pathogens have different drug resistance. According to the results of bacterial culture and drug sensitivity test, Avoid drug abuse, more accurate and safe treatment.