外耳炎的常見類型
//hzlcwl.cn2009-10-15 14:55:35 來源:全民健康網
外耳炎可分為兩類,一類為局(ju)(ju)限性外(wai)(wai)(wai)(wai)耳炎,又稱(cheng)(cheng)外(wai)(wai)(wai)(wai)耳道癤;另一類為外(wai)(wai)(wai)(wai)耳道皮膚的(de)彌漫性炎癥,又稱(cheng)(cheng)彌漫性外(wai)(wai)(wai)(wai)耳炎。外(wai)(wai)(wai)(wai)耳道皮膚外(wai)(wai)(wai)(wai)傷或(huo)局(ju)(ju)部抵抗力(li)降低時(shi)易(yi)發病,如挖耳、進水、化膿(nong)性長(chang)期膿(nong)液的(de)刺(ci)激等。此(ci)外(wai)(wai)(wai)(wai),有變(bian)應體質和(he)者易(yi)反復(fu)發作。常(chang)見致(zhi)病菌(jun)(jun)為金黃色葡萄球(qiu)菌(jun)(jun)、鏈(lian)球(qiu)菌(jun)(jun)、綠膿(nong)桿菌(jun)(jun)和(he)變(bian)形桿菌(jun)(jun)等。
局限性外耳炎:耳痛劇烈,張口咀嚼時加重,并可放射至同側頭部。多感全身不適,體溫或可微升。當腫脹嚴重堵塞外耳道時,可有及聽力減退。檢查有耳廓牽引痛及耳屏壓痛,外耳道軟骨部皮膚有局限性紅腫。紅腫成熟破潰后,外耳道內積膿流出耳外,此時耳痛減輕。外耳道后壁癤腫嚴重者可使耳后溝及乳突區紅腫,應注意與急性乳突炎鑒別。急性乳突炎者多有急性或慢性化膿性中耳炎病(bing)史,發(fa)熱較(jiao)明顯(xian),無耳廓牽拉痛(tong),而(er)有乳突(tu)部壓痛(tong);有鼓膜(mo)穿孔或鼓膜(mo)明顯(xian)充血,膿液較(jiao)多。
彌漫(man)性外耳(er)(er)(er)炎:急性者(zhe)表現為(wei)耳(er)(er)(er)痛(tong),可(ke)流(liu)出。檢查亦有耳(er)(er)(er)廓牽拉痛(tong)及耳(er)(er)(er)屏壓痛(tong),外耳(er)(er)(er)道(dao)(dao)(dao)皮膚(fu)彌漫(man)性紅腫,外耳(er)(er)(er)道(dao)(dao)(dao)壁上可(ke)積聚(ju)分泌物(wu),外耳(er)(er)(er)道(dao)(dao)(dao)腔變窄(zhai),耳(er)(er)(er)周淋巴結(jie)腫痛(tong)。慢(man)性者(zhe)耳(er)(er)(er)發癢,少量滲出物(wu)。外耳(er)(er)(er)道(dao)(dao)(dao)皮膚(fu)增厚、皸裂、脫(tuo)屑,分泌物(wu)積存,甚至(zhi)可(ke)造(zao)成(cheng)外耳(er)(er)(er)道(dao)(dao)(dao)狹窄(zhai)。
局(ju)限性(xing)外耳炎檢查有耳廓(kuo)牽(qian)引痛(tong)(tong)及(ji)耳屏(ping)壓痛(tong)(tong),外耳道(dao)(dao)軟骨部皮膚有局(ju)限性(xing)紅(hong)腫。外耳道(dao)(dao)后壁(bi)癤腫嚴重(zhong)者可使耳后溝(gou)及(ji)乳(ru)突(tu)區紅(hong)腫。彌(mi)漫性(xing)外耳炎檢查亦有耳廓(kuo)牽(qian)拉痛(tong)(tong)及(ji)耳屏(ping)壓痛(tong)(tong),外耳道(dao)(dao)皮膚彌(mi)漫性(xing)紅(hong)腫,外耳道(dao)(dao)壁(bi)上可積(ji)聚分泌物,外耳道(dao)(dao)腔變(bian)窄,耳周淋(lin)巴(ba)結腫痛(tong)(tong)。外耳道(dao)(dao)皮膚增厚、皸裂、脫屑(xie),分泌物積(ji)存(cun),甚至可造(zao)成外耳道(dao)(dao)狹窄。
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