潜水相关内耳气压伤  

Diving-related inner ear barotrauma

作　　者：刘文武[1] 俞旭华 李慈[1] 徐佳骏[1] 徐齐兵 方以群[1] LIU Wen-wu;YU Xu-hua;LI Ci;XU Jia-jun;XU Qi-bing;FANG Yi-qun(Department of Diving and Hyperbaric Medical Research,Naval Medical Center,Naval Medical University(Second MilitaryMedical University),Shanghai 200433,China;Clinic of Warship 862,No.92118 Troop of PLA Navy,Ningbo 315500,Zhejiang,China)

机构地区：[1]海军军医大学(第二军医大学)海军特色医学中心潜水与高气压医学研究室,上海200433 [2]海军92118部队862船医务室,宁波315500

出　　处：《海军军医大学学报》2022年第5期555-560,共6页Academic Journal of Naval Medical University

基　　金：国家自然科学基金面上项目(81772015,81901912);国防科技创新特区项目(19-163-16-ZD-020-008-01.03)。

摘　　要：潜水过程中,环境压力变化可导致内耳气压伤,而反复捏鼻鼓气平衡中耳压力是导致内耳气压伤的主要原因。捏鼻鼓气会增加脑脊液压力和内耳压力,内耳外淋巴液和中耳之间的压力梯度随之增大,导致圆窗膜或卵圆窗膜破裂、外淋巴液从内耳泄漏,引起内耳气压伤。内耳气压伤虽然发病率较低,却是影响潜水员适潜性的一个重要原因。罹患内耳气压伤的潜水员可出现眩晕、耳鸣和听力丧失等非特异性症状,若前庭受累还可导致恶心和呕吐。内耳气压伤主要与内耳减压病鉴别。内耳气压伤的治疗方式包括加压治疗、保守治疗和手术修复。本文对潜水相关内耳气压伤进行简要介绍。During diving,the change in ambient pressure may cause inner ear barotrauma,which is closely related to the repeated Valsalva maneuver for equilibration of middle ear pressure.Valsalva maneuver may increase the cerebrospinal fluid pressure and inner ear pressure,and therefore the pressure gradient between inner ear lymph and middle ear increases,which may cause the rupture of the round or oval window and the perilymph leakage from the inner ear,leading to inner ear barotrauma.Although the incidence of inner ear barotrauma is low,it is an important factor affecting the fitness to dive in divers.Divers with inner ear barotrauma usually experience non-specific symptoms such as dizziness,tinnitus,and hearing loss.The vestibular involvement may even cause nausea and vomiting.The inner ear barotrauma is mainly distinguished from inner ear decompression sickness.Treatments for inner ear barotrauma include compression therapy,conservative treatment,and surgical repair.This paper briefly introduces the current knowledge about diving-related inner ear barotrauma.

关 键 词：潜水 内耳 气压伤 外淋巴瘘 减压病 

分 类 号：R845.25[医药卫生—航空、航天与航海医学]