Shikani A H
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Ear Nose Throat J. 1996 Aug;75(8):524-6, 528.
Sinus packs that are used for hemostasis and the prevention of synechiae following endoscopic sinus surgery frequently get colonized with bacteria from the infected sinus, which increases the risk for infection. This study was conducted in an attempt to characterize the bacterial flora of the chronically infected sinus, and to evaluate whether direct installation of antibiotics into the sponge inhibits bacterial growth. Bacteria were cultured from 89% of the sinuses at surgery, and in 67% of the cases, the same bacteria were recovered from the sinus dressings one week later. When the Merocel sinus dressing was expanded with a combination of polymyxin, neomycin and hydrocortisone at the time of surgery, a 36% decrease in bacterial growth was observed, along with a decrease in the severity of pain associated with removal of the pack. This supports the concept of using an antibiotic for the expansion of the sponge following endoscopic sinus surgery.
用于鼻内镜鼻窦手术后止血和预防粘连的鼻窦填塞物常常被感染鼻窦中的细菌定植，这增加了感染风险。本研究旨在对慢性感染鼻窦的细菌菌群进行特征分析，并评估将抗生素直接注入海绵中是否能抑制细菌生长。手术时从89%的鼻窦中培养出细菌，67%的病例在一周后从鼻窦敷料中培养出相同细菌。当在手术时用多粘菌素、新霉素和氢化可的松的组合对美罗海绵鼻窦敷料进行扩张时，观察到细菌生长减少36%，同时与取出填塞物相关的疼痛严重程度也有所降低。这支持了在内镜鼻窦手术后使用抗生素扩张海绵的理念。
