咽鼓管表面活性物质对气压损伤性中耳炎咽鼓管开放功能作用的实验研究  

An experimental study on the therapeutic effects of eustachian tube surfactant in barotitis media

作　　者：冯立宁[1] 苟琳[1] 郭群[1] 陈文弦[2] 丛锐[3] 郑国玺[4] 

机构地区：[1]第四军医大学航空航天医学系临床医学教研室,西安710032 [2]第四军医大学唐都医院耳鼻咽喉科 [3]第四军医大学西京医院耳鼻咽喉科 [4]西安交通大学医学院第二附属医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉科杂志》2002年第11期613-615,共3页Journal of Clinical Otorhinolaryngology

基　　金：国家自然科学基金(No.39900171);全军医药卫生科研基金(No.98Q070)资助项目

摘　　要：目的:探讨咽鼓管表面活性物质(ETS)在气压损伤性中耳炎(BM)咽鼓管开放功能中的作用及其治疗效果。方法:应用低压舱建立气压损伤性中耳炎动物模型,观察正常豚鼠及分别应用天然ETS、人工ETS、人工磷脂及生理盐水冲洗的BM豚鼠咽鼓管开放必须压(POL)的变化。并观察人工ETS对:BM的治疗效果。结果:实验组POL明显高于正常对照组,其差异有极显著性意义(P<0.01),天然ETS使BM的POL由(11.98±1.93)kPa降至(6.1l±1.69)kPa,人工ETS使POL由(11.91±1.87)kPa降至(6.67±1.72)kPa,其差异均有极显著性意义(P<0.01);天然ETS降低POL作用与人工ETS比较,其差异无显著性意义(P>0.05);人工磷脂使POL由(11.86±1.57)kPa降至(8.61±1.88)kPa,其差异亦有显著性意义(P<0.05),但与天然ETS和人工ETS相比,其降低POL作用明显减弱(P<0.05)。应用人工ETS 1周后观察鼓膜状况、鼓室渗出及听阈均有明显好转,与对照组比较,差异有显著性意义(P<0.05)。结论:人工ETS同天然ETS一样,具有促进BM咽鼓管开放功能的作用,人工ETS对BM的治疗具有一定疗效。Objective:To observe the effect of surfactant on eustachian tube (ET) on the opening of ET as well as it's therapeutic role in barotitis media (BM). Method; 50 guinea pigs were successfully established as BM models by stimulated ascending in altitude chamber. Parts of the models were treated with by middle ear flushing with nature ETS, artificial ETS, artificial phospholipid and saline, after which the eustachian tube pressure opening level (POL) of each group was tested. Others were injected with 1ml artificial ETS in on side of the middle ear, and 1ml of saline in the other served as control. Result: Natural ETS decreased the POL from 11. 98 to 6. 11 kPa ( P < 0. 01) ; Artificial ETS reduced the POL from 11, 91 to 6. 67 kPa( P <0. 01) , there were no significant differences between the two groups. Artificial phospholipid decreased the POL from 11. 86 to 8. 61 kPa( P <0. 05), which was not as effective as natural ETS. While the POL of saline group remained unchanged. After one week of artificial ETS treatment, the congestion in drum membrane alleviated, the hearing threshold of ETS group improved and the effusion in tympanic cavity lessened. Conclusion; The results suggest that artificial ETS is as effective as nature ETS to facilitates the opening of eustachian tube. Artificial ETS may exert therapeutic effects on BM.

关 键 词：咽鼓管开放功能 咽鼓管 表面活性物质 气压损伤性中耳炎 开放必须压 BM 航空医学 发病机制 

分 类 号：R856.76[医药卫生—航空、航天与航海医学]