60例门诊外耳道炎分泌物真菌培养结果和治疗效果分析

发布时间：2018-05-31 21:11

本文选题：外耳道炎 + 耳内镜　；参考：《临床耳鼻咽喉头颈外科杂志》2015年10期

【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(P0.05)。2组临床疗效及真菌学疗效比较差异无统计学意义(P0.05),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。
[Abstract]:Objective: to explore the diagnosis and treatment effect of external auditory meatus fungal infection through symptom, endoscopy and secretion fungal culture in outpatients, so as to improve the importance of external auditory meatus fungal infection. Identify better treatments. Methods Sixty patients who were diagnosed as external auditory meatus in Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial Hospital, 2013-10-2014-08, were diagnosed by their symptoms, endoscopic manifestations and fungal culture results. Among them, 42 cases were confirmed fungal infection, 42 cases were positive for fungal smear, 34 cases were isolated aspergillus, 8 cases were Candida, 5 cases were combined with bacterial infection, 4 cases were Gram-positive bacteria, 1 case was Pseudomonas aeruginosa. 42 patients with fungal infection of external auditory meatus were divided into observation group (n = 21) and control group (n = 21) according to their drug compliance. There was no medication in the observation group, and the control group was treated with external auditory meatus smear for 1 / 2 times / d for 1 / d / 1 week, and then followed up for 2 weeks and then reexamined for fungal examination after 2 weeks. Results in the observation group, 16 cases were cured, 5 cases were effective and the total effective rate was 100%. In the control group, 19 cases were cured and 2 cases were effective. There was no significant difference in the total effective rate between group 100.2 and group 100.2. There was no significant difference in clinical and mycological efficacy between the two groups. The average time of treatment was 2.5 days in the observation group and 8 days in the control group. Conclusion: endoscopy is a quick method to diagnose fungal infection of external auditory meatus, and it is a good method to apply compound resorcinol solution to smear external auditory canal after removing secretion of external auditory canal under endoscope. This method has the advantages of quick effect, short course of treatment, small trauma, high cure rate, high compliance and good short-term effect. As a convenient, safe and effective method, it can be popularized in clinic.
【作者单位】：佛山市顺德区新视代眼科医院耳鼻咽喉科;中山大学孙逸仙纪念医院耳鼻咽喉科;中山大学新华学院听力言语科学系;
【基金】：2013年广东省科技计划项目(No:2013B022000051)
【分类号】：R764.11

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