全耳廓化脓性软骨炎——防止毁容性耳畸形的治疗  

Suppurative Chondritis Involving Whole Auricle:A New Therapy for Avoiding Devastating Auricular Deformity

作　　者：马婕[1] 周祥宁[2] 陈家萍[2] 郭彩云[1] 史仲魁[1] 

机构地区：[1]河北省邯郸市第三医院,056001 [2]天津医科大学第一中心医院

出　　处：《天津医药》1996年第4期224-227,共4页Tianjin Medical Journal

摘　　要：1988年以来用新方法治疗6例经手术探查和组织病理学检查证实的化脓性软骨炎。新疗法系采用暴露性引流加彻底清创手术,将有炎症和坏死的软骨以及肉芽组织完全切除。根据细菌培养和药敏试验,术中用高敏抗生素冲洗、浸泡,术毕填入浸透高敏抗生素的纱条。耳廓前面和后面垫以干纱布固定包扎。术后每日换药,用高敏抗生素冲洗,更换伤门内的抗生素纱条。全身使用高敏抗生素。本组6例均在1个月左右治愈而无炎症复发,术后随访6个月至6年零9个月发现2例耳廓外形基本正常,4例耳廓结构得到保存,仅有局限性皮肤增厚突起的轻度畸形。这些病例都避免了过去重度耳廓化脓性软骨炎后遗的菜花耳或耳廓塌陷之类的毁容性畸形。Six patients with severe suppurative chondritis involving the whole auricle confirmed by exploratory surgery and pathologic study had been treated since 1988. A new therapy was developed for those patients in order to avoid devastating deformity of the auricle. Wide incision for drainage and exploration was made followed by extensive debridement to excise infected and necrotic cartilage as well as inflammatory granulation. Attempts were made to preserve healthy cartilage whenever possible. Gauze wick impregnated with hypersensitive antibiotic solution according to culture and sensitivity assay was put into the wound at the end of surgery and changed daily. Flufid gauzes were placed in front of and behind the auricle to maintain the auricle contour during dressing. The patients were maintained on systemic hypersensitive antibiotics treatment as well. All patients in this series were cured of the disease in about one month without cauliflower like deformity or collapse of the auricle.

关 键 词：全耳廓 化脓性软骨炎 抗生素 引流 清创术 

分 类 号：R764.105[医药卫生—耳鼻咽喉科]