慢性中耳炎合并鲍氏不动杆菌感染的临床特点分析

Infection of chronic otitis media with Acinetobacter:6 cases report

目的:探讨慢性中耳炎合并鲍氏不动杆菌感染患者的临床特点、诊断方法及预后情况。方法:回顾性分析6例慢性中耳炎合并鲍氏不动杆菌感染患者的临床资料,包括病史、临床表现、实验室检查、听力学、内耳CT及MRI等影像学特征、治疗方法及预后等,总结慢性中耳炎合并鲍氏不动杆菌感染患者的临床特点及诊断治疗方法。结果:6例患者中4例伴基础疾病,5例以耳流脓为主要症状,1例以耳痛为首发症状,1例伴有面瘫症状,3例伴有不同程度的眩晕,2例伴有头痛。4例伴不同程度耳鸣,纯音听阈检查均大于40dB,CT检查4例患者伴有骨质破坏征象,常规滴耳液治疗无效;5例耳流脓患者经手术治疗得以改善,其中3例显效,2例复发。结论:慢性中耳炎合并鲍氏不动杆菌感染多发生在中老年、体质较差的患者,病史较长且有长期应用抗生素类滴耳液病史,耳流脓、体力下降程度较高,多伴有头痛、头晕及面瘫等并发症症状,常规治疗方法复发率较高,且漏诊率高。根治手术、敏感抗生素联合治疗,效果确切。

Objective：To investigate the clinical characteristics, diagnostic methods and prognosis of patients with chronic otitis media with Acinetobacter infection. Method：Retrospective analysis of clinical data of 6 cases of chronic otitis media complicated with Acinetobacter infection. Including history, clinical manifestations, laboratory examination, audiology, inner ear, CT, MRI imaging characteristics, treatment and prognosis of etc. to summa- rize the clinical characteristics, diagnosis and treatment of chronic otitis media with Acinetobacter infection. Result： The age was between 17 years old and 61 years old （Median age 30 years） . Two of them was male and 4 were fe- male. Four cases were had underlying diseases. Five cases with main symptom of cholesteatoma, 1 case with ear- ache symptoms, and 1 case with facial paralysis symptoms. Four cases had vary degrees of physical decline and de- struction of bone. After surgery treatment, five patients improved ear pus, among 3 cases was cured, 2 cases of recurrence. Conclusion：Chronic otitis media with Acinetobacter infection occurs in the patient with elderly, poor physical constitution. However, the recurrence rate of conventional treatment is higher. The disease has high misdiagnosis rate. Operation combined with sensitive antibiotic therapy is a radical cure method.