聚维酮碘治疗化脓性中耳炎真菌感染及对听力影响研究

Effect of povidone iodine on treatment of suppurative otitis media patients with fungal infection and its influence on hearing

目的研究聚维酮碘治疗化脓性中耳炎患者真菌感染效果。方法选取耳鼻喉科化脓性中耳炎真菌感染患者126例,分为治疗组和对照组(各63例)。对照组采用基础疗法,治疗组联合聚维酮碘溶液治疗。观察和比较两组患者前后真菌检出率和临床症状及听力状况等。结果治疗组临床痊愈率57.14%、总有效率96.83%,高于对照组(P<0.05)。治疗后,治疗组真菌共检出9株、检出率14.29%低于对照组,气导(AC)、骨导(BC)、气骨导差(ABG)水平低于对照组、改善值高于对照组(P<0.05),两组患者AC、BC、ABG水平均较同组治疗前下降(P<0.05);治疗后,治疗组CCES量表评分(89.00±5.60)分,高于对照组(P<0.05);生存质量显著提高率66.67%及对病耳担心程度明显下降率66.67%、轻微下降率30.16%,均高于对照组(P<0.05)。生存质量无变化率3.17%、轻微下降率0.00%及对病耳担心程度显著提高率0.00%、无变化率3.17%,均低于对照组(P<0.05)。结论采用聚维酮碘治疗利于提高化脓性中耳炎患者真菌清除率、减轻炎症反应、改善内环境。

OBJECTIVE To observe the effect of povidone iodine on treatment of the patients with suppurative otitis media. METHODS A total of 126 suppurative otitis media patients with fungal infection who were treated in otolaryngology department were enrolled in the study and divided into the treatment group and the control group, with 63 cases in each group. The control group was treated with conventional therapy, while the treatment group was given the conventional therapy combined with povidone iodine solution. The isolation rate of fungi, clinical symptoms and hearing status were observed and compared between the two groups of patients before and after the treatment. RESULTS The clinical cure rate of the treatment group was 57.14%, significantly higher than that of the control group;the total effective rate of the observation group was 96.83%, significantly higher than that of the control group( P<0.05). Totally 9 strains of fungi were isolated from the treatment group after the treatment, the isolation rate of fungi of the treatment group was 14.29%, significantly lower than that of the control group. The levels of air conduction(AC), bone conduction(BC) and air-bone gap(ABG) of the treatment group were significantly lower than those of the control group, and the improvement value of the observation group was significantly higher than that of the control group( P<0.05), the levels of AC, BC and ABG of the two groups of patients were significantly lower after the treatment than before the treatment( P<0.05);the score of CCES scale of the observation group was(89.00±5.60) points after the treatment,significantly higher than that of the control group(P<0.05). The rate of improvement of quality of life, rate of significant decrease in worrying about the sick ears and rate of slight decrease of the observation group were respectively 66.67%, 66.67% and 30.16%,significantly higher than those of the control group(P<0.05). The rate of no change in quality of life, rate of slight decrease, rate of significant increase in worrying about the sick ears and rate of no change of the observation group were respectively 3.17%, 0.00%, 0.00% and 3.17%,significantly lower than those of the control group(P<0.05). CONCLUSION Povidone iodine may raise the clearance rate of fungi in the patients with suppurative otitis media, alleviate inflammatory reactions and improve internal environment.