不同体位麻黄碱滴鼻对高压氧治疗所致中耳气压伤的预防效果及患者耐受性

The preventive effect and patients' tolerability of ephedrine nasal drops on different body positions in the treatment of middle ear barotrauma caused by hyperbaric oxygen

目的探讨不同体位麻黄碱滴鼻对高压氧治疗所致中耳气压伤的预防效果及患者耐受性的影响。方法选取我院2014年1月~2015年12月收治的首次行高压氧治疗的260例患者作为研究对象,采取随机数字表将其分成两组,每组130例。两组患者均于治疗第1~3d进舱前采用麻黄碱滴鼻,观察组滴鼻时采取的体位是平卧位头部后仰侧转45°,对照组则采取平卧位头部后仰,比较两组患者用药3d后中耳气压伤发生情况以及高压氧治疗过程中患者的耐受性。结果观察组中耳气压伤发生率为5.38%,相对于对照组的15.38%有明显下降（P〈0.01）;观察组鼓膜损伤程度明显轻于对照组（P〈0.01）;观察组高压氧治疗耐受率为93.85%,相对于对照组的86.15%有明显上升（P〈0.05）。结论平卧位头部后仰并侧转45°给予1%盐酸麻黄碱滴鼻液滴鼻可有效预防中耳气压伤的产生,提高患者对高压氧治疗的耐受性。

Objective To investigate the preventive effect and patients＇ tolerability of ephedrine nasal drops on different body positions in the treatment of middle ear barotrauma caused by hyperbaric oxygen. Methods 260 patients with the first hyperbaric oxygen therapy in our hospital from January 2014 to December 2015 were selected as the research subjects, with the method of random number table who were divided into two groups,130 cases in each. Ephedrine was adopted for patients in the two groups after1~3d of the treatment before entering the cabin. The body position of the observation group when receiving nasal drops is head back side to 45 degrees.The control group adopted the position of supine head thrown back. The situation of middle-ear barotrauma and patients＇ tolerance in the process of hyperbaric oxygen treatment were compared after three days of medication. Results The incidence of middle ear pressure in the observation group was 5.38%, which significantly decreased compared with 15.38% in the control group（P 0.01）; the damage degree of the membrane in the observation group was significantly less than that in the control group（P〈0.01）; the tolerance rate of hyperbaric oxygen treatment of the observation group was 93.85%, and compared with 86.15% in the control group there was a significant increase（P〈0.05）. Conclusion Supine head with a side turn of 45 degrees with 1% ephedrine hydrochloride nasal drops can effectively prevent middle ear barotrauma and improve the tolerability towards hyperbaric oxygen therapy.