目的:探讨慢性鼻窦炎鼻内镜鼻窦手术(ESS)后迁延不愈者鼻窦分泌物的细菌学特征。方法:对143例慢性鼻窦炎患者行ESS,术中取筛窦分泌物做细菌培养和药物敏感试验(术前组),术后随访6个月以上,对其中未达治愈标准的49例在鼻内镜下取筛窦分泌物做细菌培养和药物敏感试验(术后组),2组结果进行比较分析。结果:术前组检出细菌153株,术后组检出细菌65株,2组均以G+球菌为主,其差异无统计学意义;术后组G-杆菌检出率显著高于术前组;而厌氧菌检出率显著低于术前组;对常用抗生素耐药的菌株比例在术后组显著高于术前组。结论:细菌感染是慢性鼻窦炎术后迁延不愈的原因之一,其致病菌仍以G+球菌为主,但G-杆菌的感染较术前增多,而厌氧菌的感染较术前减少;术后致病菌的耐药性增加。因此,对鼻内镜鼻窦手术后迁延性鼻窦炎的抗生素治疗,应建立在细菌培养和药敏试验的基础上。 Objective: To investigate the bacteriological characteristics of sinus secretions in patients with chronic sinusitis after endoscopic sinus surgery (ESS). Methods: ESS was performed in 143 patients with chronic sinusitis. Bacterial culture and drug sensitivity test (preoperative group) were performed in the patients with ethmoid sinus bleeding. The patients were followed up for more than 6 months. Among 49 cases, Nasal endoscopic sinus secretion taken bacterial culture and drug sensitivity test (postoperative group), two groups of results for comparative analysis. Results: 153 strains of bacteria were detected in the preoperative group and 65 strains of bacteria were detected in the preoperative group. The two groups were mainly G + cocci, the difference was not statistically significant; the detection rate of G- Group, while the detection rate of anaerobic bacteria was significantly lower than that of preoperative group. The proportion of strains resistant to commonly used antibiotics in postoperative group was significantly higher than that in preoperative group. CONCLUSIONS: Bacterial infection is one of the causes of postoperative persistent unhealed chronic sinusitis. The pathogenic bacteria are still mainly G + cocci, but the G- bacilli increased more than preoperatively, while the anaerobic bacteria decreased more than preoperatively ; Postoperative pathogenic bacteria increased resistance. Therefore, the antibiotic treatment of persistent sinusitis after endoscopic sinus surgery should be based on bacterial culture and susceptibility testing.