病灶根治对扁桃体炎合并肾炎的疗效观察

目的　探讨病灶根治对慢性扁桃体炎合并肾炎的疗效。方法　对与肾炎反复发作相关的慢性扁桃体炎患者 ,根据咽拭子细菌培养结果选用敏感的抗生素静脉滴注 2周 ,然后在局麻下行扁桃体剥离手术并将扁桃体及其隐窝内分泌物送细菌室进行培养、并做药物敏感试验。通过测定手术前、术后 1周、2周、4周、1年的2 4h尿蛋白定量及 1h尿RBC计数的变化评价治疗效果。结果　扁桃体内培养出的致病菌依次为 :需氧菌中 ,β 溶血性链球菌 (5 7% )、葡萄球菌 (2 0 % )、肺炎链球菌 (11% )、流感嗜血杆菌 (7% )、绿脓杆菌 (5 % ) ,最常见的厌氧菌是类杆菌 ,自手术后 4周起血尿、蛋白尿明显减少 (P <0 .0 5 )。随访 1年以上无复发。结论　病灶根治对于慢性扁桃体炎合并肾炎的疗效显著。

The Pathogenic Bacteria of Tonsillitis Associated with Chronic Glomerular Nephritis and the Therapeutic Effect of Removal of Tonsil to Chronic Glomerular Nephritis

Objective To investigate the pathogenic bacteria of chronic tonsillitis associated with the recurent of glomerular nephritis,and evaluate the therapeutic effect of removal of tonsil to chronic tonsillitis with glomerular nephritis.Methods Use sensitive antibotics 2 weeks according to the result of pharyngeal germiculture,then perform tonsillectomy under local anesthesia and cultivate the bacteria obtained from the tonsil and examine the sensitivity of drags.Measare the total uric protein volume per 24 hours and uric RBC count per hour,respectively one week before the operation and one week,two weeks,four weeks and a year after the operation.Results The pathogenic bacteria cultivated were Streptococcus pyogenes( 57%),Staphylococcus(20%),S.pneumonia(11%),Haemophilus influenzae(7%) and Pseudomonas aeruginosa(5%).The hematuria and proteinuria decrease dominately 4 weeks after the operation(P<0.05).Conclusion The therapeutic effect of removal of tonsil to glomerular nephritis with chronic tonsillitis is greatly significant.