目的 探讨在耳内镜下向外耳道内注入醋酸曲安奈德益康唑乳膏治疗外耳道炎性反应的临床疗效。方法 选取解放军总医院第三医学中心2015-01至2018-10门诊诊治的404例外耳道疾患患者(双耳63例),共467耳,其中真菌性外耳道炎424耳,外耳道疖肿(未破溃)43耳。将两种疾病患者分别随机分为试验组和对照组,真菌性外耳道炎每组181例,外耳道疖肿患者每组21例,试验组均予醋酸曲安奈德益康唑乳膏注入外耳道治疗,对照组中真菌性外耳道炎予制霉菌素片粉末喷洒,外耳道疖肿予红霉素软膏涂抹,治疗1周,随诊2～3周,对比观察治疗后疗效。结果 真菌性外耳道炎试验组总有效率为92.5%,对照组为67%,试验组治疗总有效率高于对照组,差异有统计学意义(P<0.05);外耳道试验组总有效率为90.5%,对照组为57.1%,试验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论 耳内镜下彻底清理外耳道,并用醋酸曲安奈德益康唑乳膏注满外耳道,治疗外耳道炎性反应,疗效确切,恢复快,值得临床推广。

Objective To explore the therapeutic effects of triamcinolone acetonide acetate cream injected into the external acoustic meatus under an otoendoscope against external acoustic meatus inflammation. Methods Four hundred and Four outpatients (467ears) diagnosed with otitis externa were selected between January 2015 and October 2018 and enrolled in this study. There were 424 ears with fungal otitis externa, and another 43 ears with otitis externa furunculosa (not burst).The patients with the two diseases were randomly divided into the test group and control group respectively. The patients in the test group were treated with triamcinolone fluconazole acetate cream, while patients with otitis externa mycotica in the control group were treated with antibacterial fragments, and those with furuncular otitis were treated with erythromycin ointment. The follow-up lasted two or three weeks. The rates of recovery and complications were investigated one week after treatment. Results The effective rate of the test group was higher (92.5% vs. 67% 90.5% vs. 57.1%) than in the control group. The effective rate of the two diseases was higher in the test group than in the control group, and the difference was statistically significant. Conclusions Treatment of inflammation in the external acoustic meatus with triamcinolone acetonide acetate cream aided by an otoendoscope is effective and facilitates recovery.