高压氧治疗并发中耳气压伤的原因分析与预防对策  

Analysis on the cause of middle ear barotrauma occurred in hyperbaric oxygen therapy and its prevention

作　　者：孔磊[1] 许立民[1] 盘晓荣[1] 宋献丽[1] 樊秋萍[1] 黄剑平[1] 陈世强[2] 

机构地区：[1]广西壮族自治区人民医院高压氧科,南宁530021 [2]广西壮族自治区人民医院耳鼻咽喉科,南宁530021

出　　处：《中国临床新医学》2011年第8期711-714,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西卫生厅自筹经费科研课题(编号:Z2008046)

摘　　要：目的探讨首次行高压氧治疗300例患者引起中耳气压伤的原因和预防对策。方法分别在进舱治疗前和HBO治疗后的第1、2、3天观察患者双耳鼓膜变化情况,询问患者升减压过程有无耳堵、耳胀、耳痛等并作记录。结果有31例(10.3%)患者发生中耳气压伤。原因与调压动作不规范、绝对咽鼓管通气阻力升高和个体咽鼓管结构的固有张力不同有关。中耳气压伤的时间均发生在加压阶段,以第1天多见,个人因素中文化程度低、思想麻痹的患者也较容易发生。结论入舱前做好安全宣教和调压动作的示教,治疗时按规范做调压动作,是避免发生中耳气压伤和减少气压伤的主要措施。Objective To analyse the causes of middle ear barotrauma and find preventions by observing 300 patients who were first treated by HBO. Methods Tympanic membrane were checked after 1^st, 2^nd and 3^rd HBO treatment ; we also asked the patients if blocked ear, swollen ear and earache were occurred in the process of pressurizing and decompression. Results Thirty-one patients （ approximately 10.3% ） suffered from middle ear barotrauma. The causes included non-standard pressure regulated action, absolute increase in eustachian tube ventilation resist- ance, difference of the inherent tension of the eustachian tube structures. Middle ear barotrauma always occurs in pressurizing step, mostly in the first day. Patients whose educational degree are not so high and is absent-minded will be suffered. Conclusion Safety education, demonstration teaching of regulating action and acceptance shall be carefully done before the patients being conveyed into oxygen tank; the patients also strictly act as doctor＇ s instructions, then the possibilities of middle ear baratrauma and damage of pressure on the patients can be prevented.

关 键 词：高压氧 中耳气压伤 预防 

分 类 号：R459.6[医药卫生—治疗学]