分泌性中耳炎与气管插管的相关性研究

发布时间：2018-05-03 05:26

本文选题：中耳炎 + 伴渗出液　；参考：《临床耳鼻咽喉头颈外科杂志》2015年04期

【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7d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10d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7d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 analyze and compare the related factors of secretory otitis media in patients with long-term tracheal intubation. Methods: the age, sex, way of intubation, duration of intubation, respiratory pattern, consciousness, gastric tube position and secretory otitis media were analyzed retrospectively in 47 patients with tracheal intubation for more than 7 days (tracheal intubation group). Twenty patients who were admitted to ICU ward without tracheal intubation at the same time served as control group. Results: in the tracheal intubation group, there were 27 cases of secretory otitis media and 9 cases of normal tympanic negative pressure, while in the control group, there were no cases of secretory otitis media and 2 cases had negative pressure of tympanic chamber. The incidence of secretory otitis media was significantly higher in patients with nasal tracheal intubation, disturbance of consciousness and more than 10 days of tracheal intubation. Nasal insertion of gastric tube promotes the occurrence of secretory otitis media. The incidence of secretory otitis media decreased in patients with glucocorticoid. Conclusion: the incidence of secretory otitis media is higher in patients with tracheal intubation for more than 7 days, and the incidence of secretory otitis media is closely related to the occurrence of secretory otitis media with ventilator using PEEP mode, nasal tracheal intubation, consciousness disturbance and secretory otitis media. The use of glucocorticoids reduces the incidence of secretory otitis media.
【作者单位】：山东大学附属省立医院耳鼻咽喉头颈外科;山东省立医院集团眼耳鼻喉医院耳外科山东省耳科学重点实验室;
【基金】：山东省自然基金面上项目(No:ZR2010HM001)
【分类号】：R764.21

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