60例门诊外耳道炎分泌物真菌培养结果和治疗效果分析  

Fungus culture of the ear discharge and therapeutic effects in 60 outpatients with otitis externa

作　　者：周梓昭 杨海弟[2,3] 郑亿庆[2,3] 熊浩[2,3] 吴敏健[2] 

机构地区：[1]佛山市顺德区新视代眼科医院耳鼻咽喉科,广东佛山510120 [2]中山大学孙逸仙纪念医院耳鼻咽喉科 [3]中山大学新华学院听力言语科学系

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第10期899-902,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2013年广东省科技计划项目(No:2013B022000051)

摘　　要：目的：通过门诊外耳道炎患者的症状、内镜下表现、分泌物真菌培养结果,探讨外耳道真菌感染的诊断和治疗效果的分析,提高对外耳道真菌感染的重视,明确更优的治疗方案。方法：60例均为2013-10-2014-08期间在中山大学孙逸仙纪念医院门诊就诊的临床拟诊为外耳道炎的患者,通过其症状、内镜下表现及外耳道分泌物真菌培养结果明确诊断。其中确诊真菌感染42例,真菌涂片阳性42例,分离出曲菌有34例,念珠菌（非白念）8例,其中合并细菌感染5例（4例为革兰氏阳性菌,1例为铜绿假单胞菌）。将42例外耳道真菌感染患者按使用治疗药物依从性不同分为观察组（21例）和对照组（21例）。2组均在耳内镜下完全清除外耳道分泌物后应用复方间苯二酚溶液涂抹外耳道,观察组无用药,对照组额外给予外耳道涂抹制霉素甘油,1~2次/d,1周后复诊,2周后复查真菌镜检。结果：2组病例治疗后观察组治愈16例,有效5例,总有效率为100%。对照组治愈19例,有效2例,总有效率100%。2组总有效率差异无统计学意义（P〉0.05）。2组临床疗效及真菌学疗效比较差异无统计学意义（P〉0.05）,观察组平均用药时间2.5d,对照组平均用药时间8d。结论：耳内镜是确诊外耳道真菌感染的一种快捷方法,同时耳内镜下完全清除外耳道分泌物后应用复方间苯二酚溶液涂抹外耳道是一种很好的治疗方法。此法起效快,疗程短,创伤小,治愈率高,依从性高,短期效果好。可作为一种方便、安全、有效的方法在临床上推广。Objective：To assess the diagnosis and therapeutic effects for fungal otitis externa by clinical symp- toms, endoscopic findings, and fungus culture of the ear discharge. Method.. Sixty outpatients diagnosed with otitis externa were enrolled in the study. All patients were treated with a thorough debridement of the ear and one anti- fungal medication regimens （compound resorcinol solution） in case of a positive fungus culture. One subgroup of patients treated with daub glycerol during 2 weeks of follow-up. Result：Positive cultures were found in 42 cases. The efficacy was observed in all patients even in those who received only ear endoscopy. Conclusion： Fungal otitis externa could be easily diagnosed by ear endoscopy. A thorough debridement of the ear and utility of compound resorcinol solution is an easy and effective approach for treatment of fungal otitis externa.

关 键 词：外耳道炎 耳内镜 真菌感染 复方间苯二酚溶液 

分 类 号：R764.41[医药卫生—耳鼻咽喉科]