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摘要: 目的: 分析比较长期气管插管患者分泌性中耳炎发生的相关因素。方法: 回顾性分析47例气管插管超过7 d患者(气管插管组)的年龄、性别、插管方式、插管持续时间、呼吸模式、意识、胃管位置与分泌性中耳炎的相关关系,同期入住ICU病房但未行气管插管的20例患者作为对照组。结果: 气管插管组中27例发生分泌性中耳炎,9例鼓室负压,11例正常;对照组未发现有分泌性中耳炎患者,有2例2耳出现鼓室负压。呼吸机应用PEEP模式、经鼻气管插管、意识障碍及气管插管超过10 d者分泌性中耳炎的发生率明显增高。经鼻插胃管促进分泌性中耳炎的发生。应用糖皮质激素患者,分泌性中耳炎的发生率降低。结论: 气管插管超过7 d的患者,其分泌性中耳炎的发生率较高;呼吸机应用PEEP模式、经鼻气管插管、意识障碍与分泌性中耳炎的发生密切相关;糖皮质激素的应用降低了分泌性中耳炎的发生率。Abstract: Objective: To explore the factors related to the occurrence of otitis media with effusion (OME) in patients with long-term tracheal intubation.Method: This retrospective study included 47 cases with endotracheal intubation more than 7 days (endotracheal intubation group) and 20 cases without mechanically ventilated in the same period(control group). The relationships between secretory otitis media with age, gender, intubation method,duration of intubation, breathing patterns, consciousness, gastric tube position were analysed.Result: The study showed 27 out of 47 patients in endotracheal intubation group had OME, 9 cases had negative pressure in the middle ear and 11 patients were normal. No OME was found in control group, and 2 cases with negative pressure in bilateral middle ear were detected. The incidence of OME was significantly increased in patients with the application of ventilator in PEEP mode or nasotracheal tube, and with conscious disturbance or tracheal intubation using for more than 10 days. The presence of OME had a significantly higher rate in patients with nasal intake subjects than the oral intake subjects. The incidence of OME decreased significantly in patients using glucocorticoid.Conclusion: The incidence of OME increased in patients applied with tracheal intubation for more than 7 days. Ventilator in PEEP mode, nasotracheal tube, and conscious disturbance were closely related with OME. Application of glucocorticoids reduced the incidence of OME.
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Key words:
- otitis media with effusion /
- tracheal intubation /
- glucocorticoids /
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[1] LIN C C,LIN C D,CHENG Y K,et al.Middle ear effusion in intensive care unit patients with prolonged endotracheal intubation[J].Am J Otolaryngol,2006,27:109-111.
[2] CHUNG H K,LIN C C,WANG C Y,et al.Improvement in otitis media with effusion in patients undergoing tracheostomy after prolonged endotracheal intubation[J].J Otolaryngol Head Neck Surg,2009,38:532-536.
[3] CAVALIERE F,MASIERI S,PROIETTI R,et al.Tympanometry for middleear effusion in unconscious ICU patients[J].Eur J Anaesthesiol,1992,9:71-75.
[4] VENTO B A,DURRANT J D,PALMER C V,et al.Middle ear effects secondary to nasogastric intubation[J].Am J Otol,1995,16:820-822.
[5] KESSER B W,WOODARD C R,STOWELL N G,et al.Middle ear effusion in adult ICU patients:a cohort study[J].Ear Nose Throat J,2013,92:340-346.
[6] LIN C C,LIN C D,CHENG Y K,et al.Middle ear effusion in intensive care unit patients with prolonged endotracheal intubation[J].Am J Otolaryngol,2006,27:109-111.
[7] CAVALIERE F,MASIERI S,LIBERINI L,et al.Tympanometry for middle-ear effusion in unconscious ICU patients[J].Eur J Anaesthesiol,1992,9:71-75.
[8] PENA M G,MASSANA E F,GUTIÉRREZ P H,et al.Middle ear effusion in mechanically ventilated patients:effects of the nasogastric tube[J].Respir Care,2013,58:273-278.
[9] LLEWELLYN A,NORMAN G,HARDEN M,et al.Interventions for adult Eustachian tube dysfunction:a systematic review[J].Health Technol Assess,2014,18:1-180.
[10] 张倩,刘长健,高下,等.分泌性中耳炎和水通道蛋白[J].国际耳鼻咽喉头颈外科杂志,2007,31(4):190-192.
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