摘要
目的探讨慢性化脓性中耳炎患者真菌感染的相关因素及其临床诊治方法,为临床资料提供参考依据。方法随机选取2011-2013年收治的124例慢性化脓性中耳炎并发真菌感染的患者,行耳内分泌物的脓液培养,将感染者分为对照组和观察组,各62例,对照组采用水杨酸乙醇耳浴治疗,观察组采用聚维酮碘进行耳浴,分析真菌感染的类型,使用单因素及回归分析的方法归纳感染相关因素,及比较分析两组的临床疗效,采用SPSS17.0统计软件进行数据分析。结果真菌感染类型有丝状菌占79.0%、白色假丝酵母菌占27.5%、近平滑假丝酵母菌占27.5%、热带假丝酵母菌占4.8%、毛霉菌属占50.0%、平滑假丝酵母菌占6.4%及克柔假丝酵母菌占4.8%,logistic回归分析其相关因素为既往中耳炎史、常滴用抗菌药物史和污水入耳史,观察组治疗有效程度明显优于对照组,其总有效率为95.2%,而对照组的总有效率为69.4%,差异有统计学意义(P<0.05)。结论慢性化脓性中耳炎合并真菌感染有丝状菌、白色假丝酵母菌、近平滑假丝酵母菌、热带假丝酵母菌、毛霉菌属、平滑假丝酵母菌及克柔假丝酵母菌等,其中以丝状菌及毛霉菌属居多,感染多与耳部病史或使用抗菌药有关,使用聚维酮碘治疗该疾病临床疗效满意,值得临床推广应用。
OBJECTIVE To explore correlative factors and clinical diagnosis and treatment of chronic suppurative otitis media with fungal infection, so as to provide reference frame for clinical data. METHODS 124 cases of patients having chronic suppurative otitis media with fungal infection Randomly collected were who were hospital- ized between 2011 and 2013. All infected patients divided were into two groups： the control group and the obser- vation group, and there were 62 cases in each group to culture the pyogenie fluids secreted by distorted ears. The control group conducted ear bath therapy with salicylic acid ethanol while the observation group conducted the therapy with povidone-iodine, and then analyzed types of fungal infection; adopted the methods of single factor and regression analysis to conclude correlative factors causing fungal infection, made a comparison to the clinical effects of the two groups. Data analysis was conducted by SPSS 17. 0 software. RESULTS Types of fungal infection included ： filamentous fungus （79.0 %）, Candida albicans （27.5 % ） , Candida para psilosis （27.5 % ）, Candida tropicalis （4.8%）, Mucor （50.0%）, Candida glabrada （6.4%） and Candida krusei （4. 8%）. According to a regression analysis, the correlative factors were the history of otitis media, taking of antibacterial agents and in-ear dirty water. The effective rate of treatment for the observation group was 95.2%, which was significantly higher than the same figure of the control group 69.4 %; the difference of effective rate indicated a statistical significance （P〈0.05）. CONCLUSION The fungal infections occurred in CSOM includes such types as filamentous fungus, C. albicans, C. parapsilosis, C. tropicalis, Mucor, C. giabrada and C. krusei, of which filamentous fungus and Mucor are in the majority. Most infections are related to the history of otitls media and taking of antibacterial agents. The therapy with povidone-iodine can produce obvious curative effect for this disease, so it is worthy to promoting for application.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第8期2008-2010,共3页
Chinese Journal of Nosocomiology
基金
中华医院感染控制研究基金项目(ZHYY-2011-032)
