耳正负压治疗对高压氧治疗突聋患者并发中耳气压伤的影响

Effect of auricular positive-negative pressure therapy on middle ear barotrama of sudden deafness treated with hyperbaric oxygen therapy

目的了解耳正负压治疗能否降低高压氧治疗突聋合并中耳气压伤发生率。方法将181例突聋患者分为对照组（113例）和治疗组（68例）。对照组同时进行常规药物和高压氧治疗；治疗组给予常规药物和高压氧治疗及在高压氧治疗前后使用鼓膜治疗仪进行耳正负压治疗。观察两纽患者中耳气压伤发生例数及特点。结果（1）两纽中耳气压伤、耳膜充血、鼓室积液发生率比较差异均无统计学意义（P〉O．05）；（2）对照组耳闷耳痛发生率明显高于治疗组，治疗组2例双耳聋者中出现耳气压伤1例（50．0％），66例单耳聋者中出现耳气压伤11例（16．7％），与对照组比较差异均有统计学意义（P〈O．05）；（3）中耳气压伤多发生于高压氧治疗前3次，其发生与病情严重程度关系不大。结论耳正负压治疗对降低高压氧治疗突聋并发中耳气压伤具有一定帮助，尤其可明显减轻耳闷耳痛的不适感，使患者易于接受高压氧治疗。

Objective To search whether the auricular positive-negative pressure treatment could reduce the incidence of middle ear barotrama（MEB） in the treatment of sudden deafness with hyperbaric oxygen therapy（HBOT）. Methods 181 cases were divid- ed into two groups, control groups （113 cases） managed conventional drug therapy and hyperbaric oxygen therapy. Treatment groups（68 cases） added the auricular positive-negative pressure treatment before or after hyperbaric oxygen therapy. The cases and characteristics of the middle ear barotrama were observed. Results （1）To compare the incidence of MEB. between two groups. 28. 3 % in control group, 17.6 % in treatment group（P〉0.05）. （2）To compare the incidence of different condition. Ear stuffy earache： 19.5% in control group,4% in other group（P〉0.05） ;hyperemia：6.2% in control group,8.8% in other group（P〉0.05） ;hydro- tympanum：2.7 % in control group, 5.9 ~ in treatment group（P〉 0.05）. In the treatment group, the incidence of MEB in sudden deafness with two ears were 50.0% ,it was 25.8% in only one ear deafness group（P〈0.05）. （3）Most of middle ear barotrama oc- curred in the first 3 times of HBOT. （4）The incidence of MEB was not related to the severity of the disease. Conclusion Auricular positive-negative pressure treatment was helpful to reduce middle ear barotrama caused by hyperbaric oxygen treatment of sudden deafness, In particular, could alleviate the discomfort of ear fullness earache, thus to make the patient easy to accept hyperbaric oxy- gen therapy.