氟康唑注射液治疗化脓性中耳炎合并真菌感染的随机对照研究  

Clinical effect of fluconazole injection on treatment of suppurative otitis media patients complicated with fungal infection:a randomized controlled study

作　　者：洪伟 蔡福果 刘慧娟 汪睿 HONG Wei;CAI Fu-guo;LIU Hui-juan;WANG Rui(Shangrao People's Hospital of Jiangxi Province,Shangrao,Jiangxi 334000,China)

机构地区：[1]江西省上饶市人民医院耳鼻喉科,江西上饶334000

出　　处：《中华医院感染学杂志》2021年第13期1977-1981,共5页Chinese Journal of Nosocomiology

基　　金：江西省自然科学基金资助项目(2019864)。

摘　　要：目的采用随机对照研究探讨氟康唑注射液治疗化脓性中耳炎合并真菌感染的临床效果。方法选取2018年1月-2020年1月江西省上饶市人民医院耳鼻喉科收治的72例化脓性中耳炎合并真菌感染患者,以随机数字表法分为对照组和研究组,各36例。两组均采用耳内镜清洁外耳道,对照组在清洁外耳道的基础上加用硝酸咪康唑乳膏,研究组在清洁外耳道的基础上加用氟康唑氯化钠注射液,均治疗2周,随访3个月。比较两组治疗2周后的临床疗效、治疗前、治疗2周后的真菌总感染清除情况、听力功能情况、血清炎性因子水平及随访期间的复发率。结果研究组治疗总有效率、真菌总感染清除率分别为91.67%、83.33%,均高于对照组(P<0.05)。与治疗前比较,治疗2周后,两组气导阈值、骨导阈值、气骨导差值、血清白细胞介素(IL)-6、IL-8、丙二醛(MDA)水平均降低,研究组低于对照组(P<0.05);而血清IL-2、超氧化物歧化酶(SOD)水平均升高,研究组高于对照组(P<0.05)。随访期间,研究组复发率3.03%,低于对照组(P<0.05)。结论氟康唑注射液可明显提高化脓性中耳炎合并真菌感染患者真菌总感染清除率,同时可减轻机体炎症反应及氧化应激反应,改善听力功能,提高疗效,且安全性较高。OBJECTIVE To observe the clinical effect of fluconazole injection on treatment of suppurative otitis media patients complicated with fungal infection by a randomized controlled study.METHODS A total of 72 suppurative otitis media patients complicated with fungal infection who were treated in the department of otolaryngology of Shangrao People’s Hospital of Jiangxi Province from Jan 2018 to Jan 2020 were enrolled in the study and randomly divided into the control group and the control group,with 36 cases in each group.Both groups were treated with otoscope for cleaning of the external auditory canal,the control group was given additional miconazole nitrate cream,and the study group was given additional fluconazole sodium chloride injection;both groups were treated for 2 weeks,and a 3-month follow-up was conducted.The clinical curative effects were compared between the two groups after the treatment for 2 weeks,the total clearance rate of fungal infection,hearing function and levels of serum inflammatory factors were compared before the treatment and after the treatment for 2 weeks,and the recurrence rate was compared between the two groups during the follow-up.RESULTS The total effective rate of treatment of the study group was 91.67%,significantly higher than that of the control group;the total clearance rate of fungal infection of the study group was 83.33%,significantly higher than that of the control group(P<0.05).The air conduction threshold,bone conduction threshold,difference value between air and bone conduction,and levels of serum interleukin(IL)-6,IL-8 and malondialdehyde(MDA)of the two groups were significantly lower after the treatment for 2 weeks than before the treatment,and the above indexes of the study group were significantly lower than those of the control group(P<0.05).The levels of serum IL-2 and superoxide dismutase(SOD)of the two groups were elevated,and the levels of above indexes of the study group were significantly higher than those of the control group(P<0.05).The recurrence rate of t

关 键 词：化脓性中耳炎 真菌感染 氟康唑注射液 白细胞介素-2 白细胞介素-6 白细胞介素-8 超氧化物歧化酶 丙二醛 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]