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[恶性外耳道炎的治疗]

[Treatment of malignant otitis externa].

作者信息

González Ortín M, López Meseguer E, Estaca Jiménez A, Sprekelsen Gassó C, González Sicilia L

机构信息

Hospital General de Murcia, Departamento de Otorrinolaringologia, Facultad de Medicina, Universidad de Murcia.

出版信息

An Otorrinolaringol Ibero Am. 1990;17(1):11-22.

PMID:2185671
Abstract

Though rare the malignant otitis externa must be borne in mind because in its precocious diagnosis is based the success of the management. Elderly people, diabetics and immunodepressed are especially exposed. The CAT is basic in order to detect the spreading of the process. The patient being admitted at a Medical center, the antibiotherapy started at once with Ceftazidine, 2 g every 12 hours via i.v. The exeresis of the e.e.ca proves sometimes necessary after control of the infection. This procedure assures the healing and prevent the recurrences some times seen. But when infection disappears owing to the success of the antibiotherapy in 2-3 weeks; the culture for Pseudomonas is negative 3 weeks later; and the previous CAT showed no spreading to the tympanal bone, the surgery must be discarded. The process is considered over when the culture for Pseudomonas aeruginosa is negative, but review of the patients is compulsory at least during half a year.

摘要

虽然恶性外耳道炎罕见,但必须牢记,因为其早期诊断是治疗成功的基础。老年人、糖尿病患者和免疫功能低下者尤其易患。计算机断层扫描(CAT)对于检测病情的扩散至关重要。患者入住医疗中心后,立即开始使用头孢他啶进行抗微生物治疗,静脉注射,每12小时2克。在控制感染后,有时需要进行外耳道及周围组织切除术。此操作可确保愈合,并防止有时出现的复发情况。但如果抗微生物治疗在2至3周内成功使感染消失;3周后铜绿假单胞菌培养结果为阴性;且之前的CAT显示病情未扩散至鼓室骨,则必须放弃手术。当铜绿假单胞菌培养结果为阴性时,该病情被视为已结束,但至少在半年内必须对患者进行复查。

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