耳内镜治疗老年人外耳道真菌病的疗效观察

Treatment for Older Patients with Otomycosis under Otoscope

目的探讨耳内镜下治疗老年人外耳道真菌病的临床治疗效果。方法选取2011～2016年我院门诊收治的86例（113耳）老年人真菌性外耳道炎患者，随机分为实验组43例（56耳）和对照组43例（57耳）。对实验组患者，需在耳内镜下清理外耳道及鼓膜表面痂皮、分泌物等，充分暴露外耳道皮肤及鼓膜后，以3％双氧水、生理盐水充分冲洗外耳道，用曲安奈德益康唑乳膏纱条填充外耳道，每日1次；对照组患者行常规普通光源下清理外耳道后，以3％双氧水、生理盐水行外耳道冲洗，同样以曲安奈德益康唑乳膏纱条置入外耳道，每日1次。两组患者治疗疗程均为4周。观察两组患者的临床症状、体征消失情况，真菌转阴率及不良反应情况。结果实验组患者临床疗效总有效率显著高于对照组患者，两组对比差异有统计学意义（P〈0．05），且两组治疗期间均未见明显不良反应。结论耳内镜下治疗老年人外耳道真菌病较传统方法具有较大优势。

Objective To explore the application of otoscope in the treatment of otomycosis in older people. Methods 76 patients （113 ears） with otomyeosis treated in our hospital from 2011 to 2016 were enrolled. The patients were randomly divided into the treatment group （43 patients, 56 cars） and control group （43 patients, 57 ears）. In the treatment group, a gauze with triamcinolone acetonide and econazole cream was inserted into external auditory canal which was rinsed fully with hydrogen peroxide and saline under otoscope once a day for 4 weeks. The patients in control groups underwent the same treatment under anterior rhinoscopy. The symptoms, fungus examination and the adverse effects were recorded. Results After 4 weeks of treatment, the overall response rate in the treatment group was significantly higher than that in the control group （ P 〈 0. 05 ）. No adverse effects appeared in two groups. Conclusion The application of otoscope in the treatment of otomycosis is more efficient than traditional procedure in older people.