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[耳霉菌病:病因与治疗的现代观点]

[Otomycosis: the modern view of etiology and management].

作者信息

Kryukov A I, Kunel'skaya N L, Kunel'skaya V Ya, Ivoilov A Yu, Turovskiy A B, Shadrin G B, Machulin A I

机构信息

Department of Otorhinolaryngology, N.I. Pirogov Russian National Research Medical University, Moscow, Russia, 117997; L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.

L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.

出版信息

Vestn Otorinolaringol. 2018;83(1):48-51. doi: 10.17116/otorino201883148-51.

Abstract

This article deals with the modern approaches to the diagnostics and treatment of fungal ear infection depending on the localization of the inflammatory process and the species of the causative fungal agent with special reference to the factors underlying the development of otomycosis under the present-day conditions based on the results of the analysis of the studies carried out during the period from 2010 to 2014. The materials of the examination of 2152 patients who applied for the medical care to various clinical departments of the Institute and were found to present with chronic inflammatory ear pathology were available for the analysis. Fungal lesions were diagnosed in 495 (23%) patients with this condition. Fungal lesions of the external ear were the predominant form of pathology; they were documented in 331 (67%) patients. Fungal otitis media was diagnosed in 85 (17%) patients and fungal lesions of the postoperative cavity in 79 (16%) patients suffering from otomycosis. 65% of the patients presenting with external fungal otitis, 20% of those with fungal otitis media, and 95% of the patients with inflammation of the postoperative cavity were infected with mold fungi dominated by the genus Aspergillus spp. 79 (16%) patients suffering from otomycosis. In 35% of the patients presenting with fungal external otitis, 80% of those with fungal otitis media, and 5% of the patients with inflammation of the postoperative cavity of the middle ear, the causative agents of the disease were the fungi Candida spp. The authors describe the modern schemes for the treatment of otomycosis elaborated at the L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology.

摘要

本文根据炎症过程的定位和致病真菌的种类,探讨了真菌性耳部感染的现代诊断和治疗方法,并特别参考了基于2010年至2014年期间开展的研究分析结果,阐述了当今条件下耳霉菌病发生发展的潜在因素。本研究所各临床科室共接收了2152例申请医疗护理的患者,对其慢性耳部炎症病理检查材料进行了分析。其中495例(23%)患者被诊断为真菌性病变。外耳道真菌性病变是主要的病理形式,331例(67%)患者有此病变记录。85例(17%)患者被诊断为真菌性中耳炎,79例(16%)耳霉菌病患者有术后腔真菌性病变。患有外耳道真菌性感染的患者中65%、真菌性中耳炎患者中20%以及术后腔炎症患者中95%感染了以曲霉菌属为主的霉菌。79例(16%)患者患有耳霉菌病。在患有外耳道真菌性感染的患者中35%、真菌性中耳炎患者中80%以及中耳术后腔炎症患者中5%,致病病原体为念珠菌属真菌。作者描述了由L.I.斯韦尔热夫斯基临床耳鼻喉科学研究所制定的耳霉菌病现代治疗方案。

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