真菌性外耳道炎患者86例的临床分析

Clinical analysis of 86 cases of fungal otitis externa

目的分析真菌性外耳道炎的临床特征,为疾病治疗提供依据。方法选取医院收治的真菌性外耳道炎患者86例,按照痊愈的中位时间进行分组,将中位数之前痊愈且无复发的对象纳入良好组,中位数后痊愈和(或)复发的对象纳入对照组。收集资料,进行因素分析。结果痊愈时间11~35 d,中位时间15 d,6个月内复发6例,则40例纳入良好组,46例纳入对照组。单纯的念珠菌感染54例(62.8%),其他感染26例(30.2%),混合感染6例(7.0%)。多因素回归分析显示,混合感染、耳闷、联合抗真菌药物、自行换药/局部用药、合并慢性鼻/喉疾病作为独立影响因素(P<0.05)。结论真菌性外耳道炎的预后存在较大差异,绝大多数可以在2~3周痊愈,但少部分疗效欠佳,部分可复发;真菌性外耳道炎的预后影响因素较多,需要重视抗真菌治疗,及早诊断混合感染,重视耳道的疏通,积极治疗合并的慢性鼻/喉疾病。

Objective To analyze the clinical characteristics of fungal otitis externa,and to provide evidence for the treatment of this disease.Methods 86 patients with fungal otitis externa were selected and divided into groups according to their median time of recovery.The median number of patients who recovered well without recurrence was included in the good group.The clinical data of patients were collected and analyzed.Results The recovery time was 11~35 days,the median time was 15 days,and 6 cases recurred within 6 months.Therefore,40 cases were included in the good group and 46 cases in the control group.Among the patients,54 cases（62.8%） were infected with simple candida,26 cases（30.2%） were infected with other bacteria,and 6 cases（7.0%） were mixed infection.Multivariate regression analysis showed that mixed infection,aural fullness,combined use of antifungal drugs,self-or local dressing change,combined with chronic nasal or throat diseases were independent influencing factors（P〈0.05）.Conclusion The prognosis of fungal otitis externa is quite different.Most patients can recover in 2~3 weeks,and a few patients have poor curative effect or even recurrence.There are many factors influencing the prognosis of fungal otitis externa.Doctors need to pay attention to antifungal treatment,early diagnosis of mixed infections,ear canal dredging,and active treatment of combined chronic nasal or laryngeal diseases.