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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 investigate the causes and preventive measures for the first time of hyperbaric oxygen treatment of 300 patients with middle ear caused by barotrauma. Methods The change of binocular tympanic membrane before and after HBO treatment were observed before and after HBO treatment respectively. The patients were asked whether there was earplug, ear swelling and earache during the decompression process. Results A total of 31 cases (10.3%) of patients had middle-ear barotrauma. Causes and regulatory action is not standardized, absolute Eustachian tube ventilation resistance and individual eustachian tube structure of the inherent tension related to different. The duration of barotrauma in the middle ear occurred in the pressurization phase, which was more common on the first day. Among the individual factors, those with low education level and thought paralysis were more likely to occur. Conclusions Before teaching, we should teach safety teaching and pressure regulating action properly and adjust the pressure regulating action during treatment. This is the main measure to avoid the occurrence of barotrauma and reduce barotrauma in the middle ear.