26例抗菌药物联合根治性手术治疗坏死性外耳道炎分析

Antibiotics combined with radical operation for necrotizing external otitis:a report of 26 cases

目的探讨抗菌药物联合根治性手术治疗坏死性外耳道炎的疗效和预后。方法收集2016—2020年某院抗菌药物联合根治性手术治疗坏死性外耳道炎的病例,对治疗过程和复发影响因素进行分析。结果共纳入26例患者,耳分泌物病原菌培养阳性率为65.38%,主要为铜绿假单胞菌和葡萄球菌。经抗菌药物联合根治性手术治疗后,病情均有所缓解,9例于术后1~5个月复发。结论根治性手术对于保守治疗不佳的坏死性外耳道炎患者具有重要作用。药敏试验阳性率低,临床医师应结合患者临床症状、体征和检查结果等制订抗菌药物治疗方案。术后复发率高,其影响因素有待进一步研究。

Objective To determine the curative effect and prognosis of antibiotics combined with radical operation for necrotizing external otitis(NEO).Methods The data of necrotizing external otitis cases from 2016 to 2020 were collected,and the course of treatment and factors of recurrence were analyzed.Results Totally 26 patients were included in the study,21 with diabetes mellitus.The positive rate of pathogenic bacteria culture in the ear secretions reached 65.38%,mainly Pseudomonas aeruginosa,Staphylococcus epidermidis and Staphylococcus aureus.All patients were treated with antimicrobial agents,and otitis relieved.The NEO relapsed in 9 patients 1-5 months after the radical operation.Conclusion Radical operation plays an important role in the treatment of NEO.Due to low positive rate of drug sensitivity test,clinicians should make antibiotic treatment plan based on clinical signs and examination results.Since the postoperative recurrence rate is high,the influence factors need to be verified.