真菌性外耳道炎的诊治体会  

Experience of diagnosis and treatment of fungal otitis externa

作　　者：祝宝莲 刘亮[1] 王忠明 Zhu Baolian;Liu Liang;Wang Zhongming(Department of Otorhinolaryngology,Childeren's Hospital of Soochow University,Suzhou,Jiangsu,215000,China;Suzhou Wuzhong People’s Hospital,Suzhou,Jiangsu,215128,China)

机构地区：[1]苏州大学附属儿童医院耳鼻咽喉科,江苏苏州215000 [2]苏州市吴中人民医院皮肤科,江苏苏州215128

出　　处：《中国医学文摘（耳鼻咽喉科学）》2020年第2期114-114,113,I0003,共3页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的探探讨真菌性外耳道炎的诊治方法,防止误诊误治。方法选取2018年3月-2018年4月该院外耳道分泌物真菌涂片阳性患者共18例,门诊医生予以清除外耳道及鼓膜表面的分泌物,双氧水清洗外耳道,并干棉球拭干,涂布复方酮康唑霜,嘱患者隔日来院清洗并换药。结果一周后患者耳痒消失,外耳道畅、清洁,鼓膜完整,标志清楚。合并耳鸣的2例患者自觉耳闷、耳鸣症状明显减轻。合并大疱性鼓膜炎的1例患者局部治疗的同时给予抗病毒治疗后耳痛症状消失,检查见鼓膜大疱消退。结论真菌性外耳道炎诊断须谨慎,注意鉴别诊断,确诊后医生帮助患者彻底清理病灶并涂药至关重要。Objective To explore the diagnosis and treatment of fungal otitis extrna,prevent misdiagnosis and mistreatment.Methods From March 2018 to April 2018 a total of 18 patients of the hospital were selected with positive fungal smear on external auditory canal secretions.The outpatient doctor helped patients cleaning the secretions on the external auditory canal and the tympanic membrane surface,rinsing the external auditory canal with hydrogen peroxid,and coating with ketoconazole cream,then asked patients to come to the hospital every other day for cleaning and dressing change.Results After one week,the patients’symptoms of itching in the ear disappeared,the external auditory canal was smooth and clean,the tympanic membrane was intact and the sign was clear.The symptoms of ear fullness and tinnitus were significantly reduced in 2 patients with combined tinnitus.The symptoms of earache disappeared and the tympanic bullae subsided after local treatment and antivirus treatment in 1 patient with bullous tympanic.Conclusions The diagnosis of fungal otitis extrna should be cautious and pay attention to differential diagnosis.After diagnosis,it is important for doctors to help patients thoroughly clean their lesions and apply medication.

关 键 词：门诊医生 干棉球 误诊误治 外耳道 耳痛 耳闷 大疱 鼓膜 

分 类 号：R76[医药卫生—耳鼻咽喉科]