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乳突根治术和/或鼓室成形术期间的菌血症

Bacteriemia during mastoidectomy and/or tympanoplasty.

作者信息

Keleş Erol, Kizirgil Ahmet, Kaygusuz Irfan, Karlidag Turgut, Yalçin Sinasi, Alpay Hayrettin Cengiz, Demir Yavuz Selim

机构信息

Firat Universitesi Firat, Elazig, Turkey.

出版信息

Otolaryngol Head Neck Surg. 2005 Sep;133(3):347-51. doi: 10.1016/j.otohns.2005.02.012.

Abstract

OBJECTIVE

To investigate the risk of bacteriemia development during surgery in patients who underwent mastoidectomy and/or tympanoplasty for chronic otitis media.

PATIENTS AND METHODS

A total of 59 patients with chronic otitis media who were undergoing tympanoplasty operation with or without mastoidectomy were enrolled in this study. Smear cultures were obtained from outer ear canal and/or middle ears of all patients before the operation. Venous blood samples were obtained before and after the operation for bacteriologic analysis. Smear cultures were also obtained from the pressure dressing material that was applied during the operation for retrieval of the outer ear canal pressure.

RESULTS

There was a 13.5% difference between the outer ear canal and/or middle ear smear cultures and ear pressure dressing smear cultures of the same case. There was no growth in the blood cultures obtained before tympanoplasty in any of the involved cases, however, in 5 (8.4%) of the culture samples obtained immediately after the tympanoplasty operation, there was bacteriemia. In the pressure dressing smear cultures obtained after the operation, 11 patients had microbial growth.

CONCLUSION

Risk of bacteriemia should be considered in the preoperative period for the patients undergoing mastoidectomy especially in patients with cardiovascular diseases, this is of importance for the dramatic consequences that might arise after the operation. We also think that bacteriemia is also one of the factors that influences graft success rate.

摘要

目的

调查因慢性中耳炎接受乳突切除术和/或鼓室成形术的患者在手术期间发生菌血症的风险。

患者与方法

本研究纳入了59例接受鼓室成形术(伴或不伴乳突切除术)的慢性中耳炎患者。所有患者在手术前均从外耳道和/或中耳获取涂片培养物。在手术前后采集静脉血样本进行细菌学分析。还从手术期间用于恢复外耳道压力的加压敷料材料中获取涂片培养物。

结果

同一病例的外耳道和/或中耳涂片培养物与耳部加压敷料涂片培养物之间存在13.5%的差异。在任何受累病例中,鼓室成形术前采集的血培养物均无细菌生长,然而,在鼓室成形术后立即采集的5份(8.4%)培养样本中,存在菌血症。在术后获得的加压敷料涂片培养物中,有11例患者有微生物生长。

结论

对于接受乳突切除术的患者,尤其是患有心血管疾病的患者,术前应考虑菌血症风险,这对于术后可能出现的严重后果至关重要。我们还认为菌血症也是影响移植成功率的因素之一。

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