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太平洋西北地区调查:鼓膜置管术后的水预防措施

Pacific Northwest survey: posttympanostomy tube water precautions.

作者信息

Poss James M, Boseley Mark E, Crawford James V

机构信息

Madigan Army Medical Center, Department of Otolaryngology-Head and Neck Surgery, Tacoma, WA 98431-1100, USA.

出版信息

Arch Otolaryngol Head Neck Surg. 2008 Feb;134(2):133-5. doi: 10.1001/archoto.2007.25.

DOI:10.1001/archoto.2007.25
PMID:18283153
Abstract

OBJECTIVES

To determine what recommendations are given to patients or parents of patients with tympanostomy tubes regarding water exposure and to elucidate any recommendation differences between primary care and specialty care physicians.

DESIGN

Clinical survey.

SETTING

General community in the Pacific Northwest, including Washington, Oregon, and Idaho.

PARTICIPANTS

Physician surveys (N = 1116) were mailed to otolaryngologists, pediatricians, and family practitioners in the Pacific Northwest. Questions included what, if any, water precautions are given to patients or parents of patients who underwent tympanostomy tube insertion. Data were tabulated and compared among the 3 physician groups.

MAIN OUTCOME MEASURES

Recommendations regarding water exposure.

RESULTS

A response rate of 23.5% (n = 263) was obtained. Most respondents were self-described otolaryngologists (n = 150) followed by family practitioners (n = 77) and pediatricians (n = 36). chi(2) Analysis of the responses from each specialty group showed an overall significant difference about swimming precautions (P < .001). Further analysis of these data shows that many otolaryngologists (47% [n = 71]) and most primary care physicians (73% [n = 83]) recommend the use of barrier devices for swimming. Another 47% of otolaryngologist respondents allow swimming without any water precautions. With regard to depth of dive, there was no statistical significance found between the physician groups.

CONCLUSIONS

Recommendations for swimming precautions are not universal among the physician groups that routinely see patients with tympanostomy tubes. Most primary care physicians and many otolaryngologists continue to prescribe water precautions to patients or parents of patients with tympanostomy tubes, despite published articles that have shown no reduction in the incidence of otorrhea from the use of barrier devices or from the avoidance of swimming.

摘要

目的

确定对于鼓膜置管患者或其家长,在接触水方面给出了哪些建议,并阐明初级保健医生和专科医生之间的建议差异。

设计

临床调查。

地点

太平洋西北地区的普通社区,包括华盛顿州、俄勒冈州和爱达荷州。

参与者

向太平洋西北地区的耳鼻喉科医生、儿科医生和家庭医生邮寄了医生调查问卷(N = 1116)。问题包括对于接受鼓膜置管的患者或其家长,是否给出了任何关于水的预防措施。对数据进行列表并在3个医生组之间进行比较。

主要观察指标

关于接触水的建议。

结果

获得了23.5%(n = 263)的回复率。大多数回复者自称是耳鼻喉科医生(n = 150),其次是家庭医生(n = 77)和儿科医生(n = 36)。对每个专科组的回复进行卡方分析显示,在游泳预防措施方面总体存在显著差异(P <.001)。对这些数据的进一步分析表明,许多耳鼻喉科医生(47% [n = 71])和大多数初级保健医生(73% [n = 83])建议游泳时使用防护装置。另有47%的耳鼻喉科医生回复者允许在没有任何水预防措施的情况下游泳。关于潜水深度,在医生组之间未发现统计学意义。

结论

对于经常诊治鼓膜置管患者的医生群体,游泳预防措施的建议并不统一。尽管已发表的文章表明,使用防护装置或避免游泳并未降低耳漏的发生率,但大多数初级保健医生和许多耳鼻喉科医生仍继续向鼓膜置管患者或其家长开出关于水的预防措施。

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Pacific Northwest survey: posttympanostomy tube water precautions.太平洋西北地区调查:鼓膜置管术后的水预防措施
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引用本文的文献

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Water protection in patients with tympanostomy tubes in tympanic membrane: a randomized clinical trial.鼓膜置管患者的耳部防水:一项随机临床试验。
Einstein (Sao Paulo). 2019 Mar 7;17(2):eAO4423. doi: 10.31744/einstein_journal/2019AO4423.
2
Water precautions for prevention of infection in children with ventilation tubes (grommets).预防带通气管(鼓膜通气管)儿童感染的水预防措施。
Paediatr Child Health. 2018 Aug;23(5):319-321. doi: 10.1093/pch/pxy078. Epub 2018 Jun 12.
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Water protection after tympanostomy (Shepard) tubes does not decrease otorrhea incidence - retrospective cohort study.
鼓膜造孔(谢泼德)管置入术后的耳部防水措施并不会降低耳漏发生率——回顾性队列研究。
Braz J Otorhinolaryngol. 2018 Jul-Aug;84(4):500-505. doi: 10.1016/j.bjorl.2017.06.009. Epub 2017 Jul 17.
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Water precautions for prevention of infection in children with ventilation tubes (grommets).预防带通气管(鼓膜通气管)儿童感染的水预防措施。
Cochrane Database Syst Rev. 2016 Jan 27;2016(1):CD010375. doi: 10.1002/14651858.CD010375.pub2.