CAJ | 학술논문

目的：探讨老年人外耳道真菌病的真菌谱、发病特点及针对性治疗。方法按真菌涂片显微镜观察及培养分离鉴定步骤进行。嗜酸性细胞及肥大细胞染色。有针对性行外耳道清洁通畅，局部抗真菌及抗过敏治疗。结果2006-2011年收集86例112耳，其中男46例（53.49%），女40例（46.51%）；中位年龄72岁。112耳耳道真菌病例中90耳为真菌培养阳性，阳性率80.36%，最多见的是曲霉菌属，有64耳(71.11％)，其次为为念珠菌感染，有13耳(14.44％)。经一个月的治疗随访，治愈84耳（75％）；好转22耳（19.64％）；无效6耳（5.36％）；总有效率94.64％。结论老年人外耳道真菌病特点：以曲霉菌为主；外耳道解剖异常、鼓膜和外耳道表皮向外移行速度减慢、耳道口毛发异常增生、外耳道异物等是其独特的致病原因；真菌引起的过敏反应是其重要的致病机制之一；耳道的清洁通畅、抗真菌及抗过敏治疗是有针对性治疗老年人外耳道真菌病同等重要的三步。
목적：탐토노년인외이도진균병적진균보、발병특점급침대성치료。방법안진균도편현미경관찰급배양분리감정보취진행。기산성세포급비대세포염색。유침대성행외이도청길통창，국부항진균급항과민치료。결과2006-2011년수집86례112이，기중남46례（53.49%），녀40례（46.51%）；중위년령72세。112이이도진균병례중90이위진균배양양성，양성솔80.36%，최다견적시곡매균속，유64이(71.11％)，기차위위념주균감염，유13이(14.44％)。경일개월적치료수방，치유84이（75％）；호전22이（19.64％）；무효6이（5.36％）；총유효솔94.64％。결론노년인외이도진균병특점：이곡매균위주；외이도해부이상、고막화외이도표피향외이행속도감만、이도구모발이상증생、외이도이물등시기독특적치병원인；진균인기적과민반응시기중요적치병궤제지일；이도적청길통창、항진균급항과민치료시유침대성치료노년인외이도진균병동등중요적삼보。
Objective To investigate the fungal spectrum,disease features and targeted therapy of ear canal fungus dis-ease in the elderly . Methods The identification methods follow as fungal smear microscopy observation and culture isolated. Staining with eosinophils and mast cells.According to the therapy of ear clean unobstructed ,topical antimycotic drugs using and antianaphylaxis treatment targeted. Results From 2006 to 2011,86 patients with 112 ears who met ear canal fungus dis-ease in the elderly with the age between 60 and 85 were collected;46 cases were males(53.49%),40 cases were fe-male(46.51%), average age was 72.The fungal culture of 90 ears in the 112 ears who met ear canal fungus disease was positive, positive rate was 80.36%.Aspergillus species was the most common fungus which had 64 ears(71.11%),Secondly for the candi-da infection,which had 13 ears(14.44%).After a month of treatment and follow-up,84 ears were cured(75%);22 ears were ef-fective(19.64%);6 ears were invalid(5.36%). The total effective rate was96.64%. Conclusions The characteristic of ear ca-nal fungus disease in the elderly:Aspergillus species are the major fungus;anatomic abnormality of ear canal,the slower speed of outward migration velocity of eardrum and ear canal epidermis ,hair abnormal proliferation of ear canal,foreign bod-ies of ear canal,all of these are its unique causes.anaphylaxis caused by fungus is one important pathogenic mechanism.ear clean unobstructed , antimycotic drugs using and antianaphylaxis treatment are the equally important steps to treat ear canal fungus disease in the elderly targeted.