耳内镜下外耳道湿疹诊疗效果分析

Analysis of eczema in external auditory canal treated by otoendoscopy

目的外耳道炎治疗较为棘手。文中观察外耳道湿疹患者的临床特征及不同药物治疗效果。方法回顾性分析东部战区总医院收治的152例外耳道湿疹患者,并根据合并细菌或真菌感染情况分为单纯外耳道湿疹组、外耳道湿疹合并细菌感染组、外耳道湿疹合并真菌感染组。所有患者均按照至少每周1次的频率复诊,予以耳内镜清理外耳道及局部涂药治疗。比较3组患者的治疗效果。结果单纯外耳道湿疹组64例(105耳)中看,35例治愈、13例好转、7例复发,9例失访;外耳道湿疹合并细菌感染组47例(51耳)中,30例治愈、12例好转、1例复发、4例失访;外耳道湿疹合并真菌感染组41例(56耳)中,15例治愈、17例好转、6例复发,3例失访。3组患者治疗效果比较,差异有统计学意义(P<0.05)。3组患者的耳内镜随访频次及总就诊时间比较,合并真菌感染组随访频次较多,治疗时间亦较长,差异均有统计学意义(P<0.01)。结论外耳道湿疹患者治疗周期较长,易复发,合并真菌感染者治疗更为困难,坚持定期耳内镜下彻底清理外耳道,方便实用疗效佳。

Objective To observe the clinical characteristics and therapeutic effects of different drugs in patients with external auditory canal eczema.Methods The clinical data of 152 patients undergoing external auditory canal eczema were retrospectively analyzed.According to whether combined with bacterial or fungal infection,they were divided into three groups,simple external auditory canal eczema group,external auditory canal eczema combined with bacterial infection group and external auditory canal eczema combined with fungal infection group.All patients were followed up at least once a week to clean the external auditory canal under otoendoscope and apply local medicine.We analyzed the differences in the treatment effects of the three groups.Results The average age of 152 patients was(38.19±15.30)years,including 67 males and 85 females.The age of onset ranged from 6 to 80 years.They complained of 101 cases of ear itching,71 cases of otorrhea and 25 cases of ear tightness,of which 82 had more than two main symptoms.64 cases(105 ears)in simple external auditory canal eczema group:35 cases were cured,13 cases improved,7 cases relapsed and 9 cases lost follow-up.47 cases(51 ears)in external auditory canal eczema complicated with bacterial infection group:30 cases were cured,12 cases improved,1 case recurred and 4 cases lost follow-up.41 cases(56 ears)in external auditory canal eczema complicated with fungal infection group:15 were cured,17 were improved,6 recurred and 3 were lost to follow-up.There was significant difference between the three groups(P<0.05).The frequency of follow-up and total treatment time of otoendoscopy in the group with fungal infection were more,and the difference was statistically significant(P<0.01).Conclusion Patients with eczema in the external auditory canal have a long treatment cycle and are easy to relapse.It is more difficult to treat patients complicated with fungal infection.The external auditory canal is cleaned thoroughly under regular otoendoscopy,which is convenient,practical and effective.