咽鼓管通气阻力与功能的相关性分析

Research on the relationship between the ventilation resistance and the function of the Eustachian tube

目的探讨中耳气压性损伤与咽鼓管通气阻力(the ventilation resistance of the Eustachian tube,VRET)的关系,分析检测通气阻力的价值。方法在鼻前孔和外耳道放置气体压力传感器,用Valsalva's法使咽鼓管(the Eustachian tube,TB)开放,检测外耳道气压变化时的鼻咽部压力作为VRET。测地面人员94人,飞行学员826人,在歼击机飞行部队作飞行验证80人,在低压舱验证30人,了解VRET与耳气压伤发病的关系。结果飞行组160耳,19耳有耳气压伤表现,含咽鼓管未开放者全部5耳,但最低的VRET仅仅2.7kPa,咽鼓管通气阻力6.4±1.9kPa;141无气压伤耳VRET3.8±2.0kPa,t=5.895,p<0.001差异有高度显著意义。低压舱组60耳,9耳有耳压伤表现VRET6.3±2.2kpa;无气压伤51耳,VRET4.0±2.0kPa,t=3.46,p<0.001,差异有高度显著意义。用通气阻力作为判定通气机能的标准,会产生较多的假阳性和假阴性。结论VRET与其通气机能是不能互相替代的两个概念。生理条件下开放咽鼓管使鼓室压平衡的是主动开放功能,但受到主动开放频率的限制。应寻找可控易行的咽鼓管被动开放法。

Objective To probe the relationship between middle ear arotraumas and the ventilative resistance of the Eustachian tube. （VRET）, to analyze the value to determine the ventialtive resistance of the tube Methods With sitting position of the subjects, the air pressure sensors were placed in their nasal cavity and external auditory canal, then sealing their external auditory canal. The subjects were ordered to do valsalva＇maneuver. After the Eustachian tube opened, the pressure in the nasopharynx while the left or right Eustachian is ventialted was printed out by a printer, which is ventilative resistance in the Eustachian tube. 94 ground crew, 826 flying cadets, were recruited. 80 combat aircraft flyers tested and verified in the flight, and 30 flyers tested and verified in the low-pressure chamber. Enable to understand the realtionship of middle ear arotraumas and the ventilative resistance of the tube. Results The ventialtive resistance of the tube is great effect on the rate of the barotalgia produced. But, while the ventilative resistance judged the function of the tube, it will be many false-negative and false-positive. Conclusion The ventilative resistance and the ventialtive function of the tube are two conceptions,and do not replaced each other. In the physiological condition, it was the subjective open function to open the tube and balancing the middle ear pressure, when the positive ventilative made for somebody, the determined the ventilative resistance of the tube would be necessary, it can be as standard to select this people. Ventilative resistance of the tube would be necessary, it can be as standard to select this people.