摘要
背景:高压氧治疗中出现中耳气压伤有诸多发病原因,但单因素或多因素致病结果不甚清楚。目的:分析高压氧治疗中出现中耳气压伤的原因并探讨防治措施。设计:回顾性研究。地点和对象:广州军区广州总医院行高压氧治疗的2116例患者中发生中耳气压伤患者84例,其中男61例,女23例,年龄6～78岁。方法:对84例中耳气压伤患者的背景因素进行分析。主要观察指标:①患者年龄、性别。②包括上呼吸道感染等引起的咽鼓管不通畅或堵塞的病因。③未做或不能配合完成调压动作的因素。④单纯操舱不当。⑤气压伤发生的时间及阶段。结果:中耳气压伤发生于加压阶段者76例,减压阶段者8例。其病因有:咽鼓管不通畅或堵塞;调压不当;操舱不当三类。其中单因素致病中以咽鼓管不通畅或堵塞最多见,多因素致病中以咽鼓管不通畅或堵塞及调压不当多见。结论:单因素及多因素均可致病,控制各类因素,搞好入舱前、舱内治疗、出舱后各个环节可预防中耳气压伤。
BACKGROUND:A variety of pathogenetic factors have been identified for their involvement in middle ear barotrauma during hyperbaric oxygen therapy,but the question of what factors,independently or in cooperation,cause the injury remains unanswered. OBJECTIVE:To analyze the reasons for middle ear barotrauma during hyperbaric oxygen therapy and explore the possible preventive measures. DESIGN:A retrospective study was conducted. SETTINGS and PARTICIPANTS:Eighty four patients with middle ear barotrauma identified from in 2 116 patients receiving hyperbaric oxygen therapy in Guangzhou General Hospital of Guangzhou Command were enrolled in this study,including 61 male and 23 female patients aged from 6 to 78 years old. METHODS:The background factors were analyzed in the 84 cases of middle ear barotrauma. MAIN OUTCOME MEASURES:The patients were analyzed for ①their age and gender distribution,②the pathogenetic factors of the auditory tube obstruction such as upper respiratory tract infections,③factor affecting the pressure adjustment either simply not performed or failed to be performed due to the patients' inability to cooperate,④inappropriate operation of the hyperbaric chamber on the part of the operator,⑤time and stage of the onset of the barotrauma. RESULTS:Middle ear barotrauma occurred in the compression stage in 76 cases and in the decompression stage in 8 cases for reasons of obstruction of the auditory tube,inappropriate pressure adjustment or inappropriate chamber operation.In the 3 classes of identified causes,obstruction in the auditory tube was the most frequent single pathogenetic factor for the injury,while auditory tube obstruction coupled with inappropriate pressure adjustment was responsible for most cases of middle ear barotrauma involving multiple factors. CONCLUSION:Both single and multiple factors can cause middle ear barotrauma during hyperbaric oxygen therapy,which can be prevented by carefully controlling all the factors involved in each procedure before,during and after the treatment.
出处
《中国临床康复》
CSCD
2004年第14期2786-2787,共2页
Chinese Journal of Clinical Rehabilitation
