老年人外耳道真菌病真菌谱分析及针对性治疗  

Fungal Spectrum Analysis and the Targeted Treatment of Ear Canal Fungal Infection in the Elderly

作　　者：陈国郝[1] 郑晓雯[1] 张琳娟[2] 程金妹[1] 张榕[1] 

机构地区：[1]福建耳鼻咽喉科研究所、福建医科大学附属第一医院耳鼻咽喉科,350005 [2]福建医科大学附属第一医院检验科,350005

出　　处：《中华耳科学杂志》2013年第4期565-568,共4页Chinese Journal of Otology

摘　　要：目的探讨老年人外耳道真菌病的真菌谱、发病特点及针对性治疗。方法按真菌涂片显微镜观察及培养分离鉴定步骤进行。嗜酸性细胞及肥大细胞染色。有针对性行外耳道清洁通畅,局部抗真菌及抗过敏治疗。结果 2006-2011年收集86例112耳,其中男46例(53.49%),女40例(46.51%);中位年龄72岁。112耳耳道真菌病例中90耳为真菌培养阳性,阳性率80.36%,最多见的是曲霉菌属,有64耳(71.11%),其次为为念珠菌感染,有13耳(14.44%)。经一个月的治疗随访,治愈84耳(75%);好转22耳(19.64%);无效6耳(5.36%);总有效率94.64%。结论老年人外耳道真菌病特点:以曲霉菌为主;外耳道解剖异常、鼓膜和外耳道表皮向外移行速度减慢、耳道口毛发异常增生、外耳道异物等是其独特的致病原因;真菌引起的过敏反应是其重要的致病机制之一;耳道的清洁通畅、抗真菌及抗过敏治疗是有针对性治疗老年人外耳道真菌病同等重要的三步。Objective To investigate the fungal spectrum, disease features and targeted therapy of ear canal fungus dis- ease in the elderly. Methods The identification methods follow as fungal smear microscopy observation and culture isolated. Staining with eosinophils and mast cells.According to the therapy of ear clean unobstructed ,topical antimycotic drugs using and antianaphylaxis treatment targeted. Results From 2006 to 2011,86 patients with 112 ears who met ear canal fungus dis- ease in the elderly with the age between 60 and 85 were collected;46 cases were males（53.49% ）,40 cases were fe- male（46.51%）, average age was 72.The fungal culture of 90 ears in the 112 ears who met ear canal fungus disease was positive, positive rate was 80.36%.Aspergillus species was the most common fungus which had 64 ears（71.11%）, Secondly for the candi- da infection,which had 13 ears（14.44%）.After a month of treatment and follow-up,84 ears were cured （75%）; 22 ears were ef- fective （ 19.64% ）;6 ears were invalid （5.36%）. The total effective rate was96.64%. Conclusions The characteristic of ear ca- nal fungus disease in the elderly： Aspergillus species are the major fungus; anatomic abnormality of ear canal, the slower speed of outward migration velocity of eardrum and ear canal epidermis , hair abnormal proliferation of ear canal, foreign bod- ies of ear canal, all of these are its unique causes.anaphylaxis caused by fungus is one important pathogenic mechanism.ear clean unobstructed, antimycotic drugs using and antianaphylaxis treatment are the equally important steps to treat ear canal fungus disease in the elderly targeted.

关 键 词：外耳道真菌病 老年人 真菌谱 致病机制 治疗 

分 类 号：R764.16[医药卫生—耳鼻咽喉科] R764.436[医药卫生—临床医学]