儿童慢性鼻窦炎合并腺样体肥大菌谱及预后相关因素分析

目的 分析慢性鼻窦炎(CRS)合并腺样体肥大患儿腺样体表面及鼻腔内细菌谱,比较腺样体手术对CRS的临床疗效及相关因素分析.方法 收集2017年10月—2019年10月就诊于北京儿童医院耳鼻咽喉科的30例CRS合并腺样体肥大患儿的相关临床资料,其中男22例,女8例.所有患儿均行腺样体和/或扁桃体切除术,术中采集腺样体表面...

Analysis of bacterial spectrum and related factors in children with chronic rhinosinusitis and adenoid hypertrophy

Objective To analyze the bacterial spectrum of adenoid surface and nasal cavity in children with chronic rhinosinusitis (CRS) and adenoid hypertrophy, and to observe the clinical effect and the related factors of adenoidectomy on CRS. Methods Clinical data of 30 children suffering from CRS complicated with adenoid hypertrophy hospitalized in our department between Oct 2017 and Oct 2019 were collected. Of them, 22 were male and 8 were female. All children underwent adenoidectomy and/or tonsillectomy. The secretion samples from the surface of adenoid and nasal cavity were collected during operation, and the bacterial spectrum was analyzed by 16S rRNA method. The patients were followed up at 3, 6 and 12 months after operation. The effect of adenoidectomy on the improvement of CRS symptoms was analyzed through the changes of upper respiratory tract infection frequency and nasal subjective scores before and after operation, and the influencing factors of adenoidectomy on the prognosis of CRS were discussed. Results The detection rates of bacteria in adenoid and nasal cavity were both 100% by 16S-RNA method. The main bacteria in the nasal cavity were Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae and Staphylococcus aureus. The main bacteria on the surface of adenoid were Streptococcus pneumoniae, Haemophilus influenzae, Fusobacterium nucleatum and Moraxella catarrhalis. Three months after adenoidectomy, the scores of subjective nasal symptoms except sneezing in all the children were significantly decreased (P<0.01). Follow-up of 12 months revealed that the upper respiratory tract infection frequency was significantly reduced (P<0.01) with a complete CRS control rate of 63.3% (19/30) and a partial control rate of 36.7% (11/30). Conclusions Adenoidectomy is an effective treatment for pediatric CRS as it can significantly improve the clinical symptoms of CRS in children. Due to the limited sample size, the relevant data show that environmental factors, bacterial spectrum and other pathogenic factors have no clear impact on the prognosis of pediatric CRS after adenoidectomy.