以耳部症状为首发症状的韦格纳肉芽肿临床分析

发布时间：2018-05-12 02:02

本文选题：韦格纳肉芽肿 + 中耳炎　；参考：《中华耳科学杂志》2017年01期

【摘要】：目的分析以耳部症状为首发症状的韦格纳肉芽肿的临床特点,探讨韦格纳肉芽肿早期诊断及治疗方法。方法回顾性分析3例以耳部症状为首发症状的韦格纳肉芽肿病例,并查阅相关文献3例,分析、总结这些病例的临床表现、诊疗经过、确诊方式、治疗方法及预后结果 6例患者早期均以耳闷、听力下降,耳痛作为首发症状,其中4例患者出现面瘫,早期均误诊为中耳炎而给予药物或手术治疗,确诊可结合临床表现,血清血标志ANCA或c-ANCA,及典型的病理表现,免疫抑制及激素治疗是目前主要治疗方案。结论以耳部症状为首发症状的韦格纳肉芽肿早期临床症状不典型,易误诊而延误治疗,ANCA或c-ANCA作为韦格纳肉芽肿的血清学标志特异性高,可以帮助早期诊断韦格纳肉芽肿。耳鼻喉科医生应加强对韦格纳肉芽肿在耳部表现的认识,早诊断、早治疗是此病预后的关键因素。
[Abstract]:Objective to analyze the clinical features of Wegener granuloma with ear symptoms as the first symptom, and to explore the early diagnosis and treatment of Wegener granuloma. Methods three cases of Wegener's granuloma with ear symptoms as the first symptom were retrospectively analyzed, and 3 cases of related literature were reviewed, and the clinical manifestations, diagnosis and treatment, and the way of diagnosis were summarized. The treatment methods and prognosis of 6 patients were as follows: early hearing loss, ear pain were the first symptoms. Among them, 4 cases had facial paralysis, and were misdiagnosed as otitis media at the early stage and given medicine or surgery. The diagnosis could be combined with clinical manifestations. Serum ANCA or c-ANCA, and typical pathological manifestations, immunosuppression and hormone therapy are the main treatment schemes. Conclusion the early clinical symptoms of Wegener's granuloma with the first symptom of ear are not typical and it is easy to be misdiagnosed and delayed treatment of Wegener granuloma is highly specific as a serological marker of Wegener's granuloma. It can be helpful in the early diagnosis of Wegener's granuloma. Otolaryngologists should strengthen the understanding of Wegener's granuloma in the ear, early diagnosis and early treatment are the key factors for prognosis of Wegener's granuloma.
【作者单位】：解放军总医院耳鼻咽喉头颈外科;东南大学附属江阴医院耳鼻咽喉科;郑州市第一人民医院耳鼻咽喉科;大连医科大学第二附属医院耳鼻喉科;
【分类号】：R764;R593.9

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