睡眠呼吸障碍儿童扁桃体及腺样体组织细菌学分析

目的　探讨睡眠呼吸障碍（sleep disordered breathing，SDB）儿童扁桃体及腺样体组织的细菌学特点。方法　经多导睡眠图监测确诊的163例SDB患儿纳入研究，其中120例同时接受扁桃体及腺样体切除术，4例接受单纯扁桃体切除术，39例接受单纯腺样体切除术，124例接受扁桃体切除术的患儿按照有无扁桃体炎反复发作的病史分为两组，扁桃体炎组71例和无扁桃体炎组53例。术中取部分扁桃体和（或）腺样体组织进行细菌学检查。结果　120例患儿中的114例（95.00%）两个部位分离出的细菌种类相同，120例中有17例（14.17%）两个部位均感染了两种细菌，混合感染的细菌种类均相同。在各个季节两个部位中金黄色葡萄球菌和流感嗜血杆菌的检出率无显著性差异（扁桃体：χ2=8.538，P =0.201；腺样体：χ2=5.427，P =0.490）。有无慢性扁桃体炎病史的扁桃体组织内的各种细菌检出率无显著性差异（χ2=3.028，P =0.387）。结论　同一个SDB患儿的扁桃体和腺样体组织检出的细菌种类几乎相同，有无慢性扁桃体炎病史的扁桃体组织内的不同细菌检出率无显著性差异。

Bacteriology of adenoids and tonsils in children with sleep-disordered breathing

OBJECTIVE This study was conducted to analyze the underlying bacterial pathogens of the tonsils and adenoids in children with sleep-disordered breathing(SDB).METHODS The core tissue from the tonsils and/or adenoids of 163 SDB children was cultured aerobically. Of the 163 cases, 120 children underwent adenoidectomy and tonsillectomy simultaneously(A+T), 39 children underwent adenoidectomy(A) and 4 tonsillectom(T) only. 124 children who underwent tonsillectomy were subdivided into two groups based on history(with or without a history of recurrent tonsillitis). 71 children with the history were enrolled in the 'recurrent tonsillitis group' and 53 children without the history were enrolled in 'non- recurrent tonsillitis group'.RESULTS Of the total 120 cases who underwent A+T, 114(95.00%) cases had same distribution of bacteria detected in both sides in the same patient. Besides this, 17 cases in whom mixed organisms were identified in both sites shared common pathogen. No significant difference in the detection rates of staphylococcus aureus and haemophilus influenzae were found when we compared seasons(Tonsil:χ2=8.538,P=0.201; Adenoid:χ2=5.427, P=0.490). No significant difference in the type and detection rate of essential bacteria was found when we compared between "recurrent tonsillitis group" and 'non-recurrent tonsillitis group' (χ2=3.028,P=0.387).CONCLUSION The bacterial isolates from the tonsils and adenoids are virtually identical in type and detection rate in the same SDB patient. The bacterial distribution of the tonsillar and adenoidal core is unaffected by the seasonal variation and history of recurrent tonsillitis.