曲安奈德益康唑乳膏不同用药方法治疗耳部真菌病

Comparative analysis of two methods for the treatment of ear mycosis with pevison

目的探讨曲安奈德益康唑乳膏不同用药方法对耳部真菌病的临床治疗效果。方法选择经涂片及镜检确诊的伴鼓膜穿孔的耳部真菌病86例,随机分为观察组和对照组,各43例。观察组耳内镜下清除外耳道真菌及分泌物后将曲安奈德益康唑乳膏置于明胶海绵上,再均匀贴于真菌感染的外耳道或残余鼓膜表面;对照组嘱患者将曲安奈德益康唑乳膏在家自行涂抹于相应部位,每日2次。两组患者每3日来院门诊复查。均治疗2周后,随访3个月,比较各组临床疗效。结果观察组治愈39例(90.7%),有效2例(4.7%),无效2例(4.7%),总有效率95.3%,随访3个月复发1例(2.4%)。对照组治愈26例(60.5%),有效1例(2.3%),无效16例(37.2%);总有效率62.8%。随访3个月治疗有效的患者复发9例(31.0%)。观察组疗效显著高于对照组(χ~2=14.508,P<0.05)。结论耳内镜下仔细清理外耳道真菌及分泌物,并准确放置涂有曲安奈德益康唑乳膏的明胶海绵,对伴有鼓膜穿孔的耳部真菌感染,疗效确切。

OBJECTIVE To compare two administration methods of triamcinolone acetonide cream for the treatment of ear mycosis with pevison. METHODSEighty-six cases diagnosed as the external auditory canal fungal infections with tympanic membrane perforation were randomly divided into observation group and control group, with 43 cases in each group. All the selected patients were positive in the external auditory meatal secretions fungus detection test, fungi and secretions of the external auditory canal are thoroughly cleaned under the endoscope. After ear canal cleaning, the obervation group was treated with Pevisone smeared on gelatin sponge which was evenly placed on the external auditory canal with fungal infection. The control group was treated with Pevisone smearing on external auditory canal by the patients themselves, twice a day. Two groups of patients come to the hospital every 3 days for review. After 2 weeks of treatment, the patients were followed up for 3 months, and the clinical efficacy of each group was compared. RESULTS The observation group was cured in 39 cases（90.7%）, effective in 2 cases（4.7%）, and ineffective in 2 cases（4.7%）, The total efficiency rate is 95.3%. 1 case recurred at 3 months of follow-up（2.4%）. While in the control group, it was cured in 26 cases（60.5%）, effective in 1 cases（2.3%）, and ineffective in 16 cases（37.2%）, the total efficiency rate is 62.8%. 9 cases recurred at 3 months of follow-up（31.0%）. The effect of the observation group was significantly higher than that of the control group（ χ~2=14.508, P〈0.05）. CONCLUSION The ear endoscope can be used to remove the external auditory canal fungus thoroughly and has good visibility. Treating external auditory canal fungi disease with tympanic membrane perforation with gelatin sponge coated with triamcinolone acetonide cream has better clinical efficacy.