呼吸不同氧浓度混合气对迟发性耳气压伤的影响  

Effects of breathing mixed gas with oxygen in different concentrations on delayed otic barotrauma

作　　者：温冬青[1] 顾昭[1] 郑学文[1] 于立华[1] 陈晓勤[1] 肖华军[1] 刘晓鹏[1] 王桂友[1] 薛利豪[1] 臧斌[1] 王颉[1] 

机构地区：[1]空军航空医学研究所,北京100142

出　　处：《解放军医学杂志》2016年第4期332-338,共7页Medical Journal of Chinese People's Liberation Army

基　　金：总后勤部重大专项资助项目(AKJ11J002)~~

摘　　要：目的观察呼吸不同氧浓度混合气对低压舱实验后人耳气压功能和听力的迟发影响。方法实验采用自身对照平衡设计,5名被试者分别在不同时间内(间隔2周以上)参加呼吸纯氧、60%氧气(含60%氧气和40%氮气)和空气3组试验。每次均在呼吸1h实验用气之后进行耳气压功能低压舱试验,观察3组被试者在不同时间点的主观症状、鼓膜充血程度、声导抗和纯音听阈等指标变化。结果纯氧组、60%氧气组和空气组被试者出舱即刻出现主观症状的耳数分别为8、2和3耳,纯氧组个别被试在出舱后3h耳闷与耳痛症状有所反复。出舱即刻3组被试者鼓膜充血程度为Ⅲ度的耳数分别为5、2和3耳,但未出现随时间延长而加重的现象。实验后3组被试者维持为A型鼓室图的耳数分别为5、6和6耳,各组鼓室图相关指标数值和声反射不全引出率随时间延长而趋向初始值,未出现明显的迟发性数据回弹。纯氧组被试者中耳压和各倍频程听阈之和在低压舱试验后改变较多,恢复较慢。结论呼吸纯氧较长时间会使参加低压舱实验的被试者耳气压伤发病率增加,症状加重,且容易诱发24h内症状反复。Objective To investigate the delayed changes in middle ear function and audition after rapid changes in ambient pressure while breathing mixed gas with oxygen in different concentrations. Methods Five healthy male subjects, sitting in the hypobaric chamber breathed pure oxygen, 60% oxygen-rich air, or air respectively, one hour before hypobaric chamber test. The interval of two tests was longer than two weeks. After 20m/s rapid changes in the ambient pressure, all the three groups were tested with subjective symptoms, degree of congestion, middle ear function and audition at four timing. Results Just after test, the amount of symptomatic ears were 8, 2 and 3 in pure oxygen group, 60% oxygen-rich air group and air group, respectively. Some subjects in pure oxygen group felt aural fullness and pain again 3 hours after tests. The amount of Ⅲ° congestion ears was 5, 2 and 3 in each group respectively with no congestion aggravation. The amount of ears with A type tympanogram was 5, 6 and 6 in each group respectively. The extraction ratio of tympanogram and acoustic reflex incomplete in all groups recovered gradually to the initial value without obviously delayed data rebound. The middle ear pressure and pure-tone threshold in subjects of pure oxygen group changed more obviously and recovered more slowly. Conclusion In hypobaric chamber test, the incidence of otic barotrauma may increase in those subjects breathing pure oxygen with symptoms aggravation and repetition within 24 h.

关 键 词：迟发性耳气压伤 低压舱 耳气压功能 听力 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]