Meng Fan-Chun, Shen Chih-Hao, Chu Chi-Ming, Shih Cheng-Ping, Lin Hung-Che, Peng Chung-Kan, Chang Shun Cheng, Huang Kun-Lun
Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Undersea Hyperb Med. 2017 Nov-Dec;44(6):551-557. doi: 10.22462/11.12.2017.6.
One of the most common complications of hyperbaric oxygen (HBO₂) therapy is middle ear barotrauma (MEB), occasionally causing otalgia. The objective of this study was to evaluate the effect of dried salted plum consumption on MEB and otalgia associated with HBO₂ therapy.
Patients undergoing the first chamber session of HBO₂ therapy were included in the present prospective randomized controlled trial. The Valsalva maneuver was administered to all patients before HBO₂. The patients were randomly divided into two groups: one that ate a dried salted plum during HBO₂ treatment and the other that did not. An otoscopic examination was performed after HBO₂ therapy. The MEB was graded according to Teed scores. The degree of otalgia was recorded using the Visual Analog Scale (VAS).
Ninety patients were enrolled. The overall incidence of MEB (Teed score grade 14) was 39.6% (21 of 53) for patients administered a dried salted plum versus 37.8% (14 of 37) for the control group (P=1.000). The incidence of mild MEB (Teed score grade 12) and severe MEB (Teed score Grade 3~4) between the two groups was not significantly different. Otalgia was present in 5.7% (3 of 53) of patients administered a dried salted plum versus 18.9% (7 of 37) for the control group (P=.085). No patients administered a dried salted plum had a VAS score ≥4 for otalgia versus 10.8% (4 of 37) for the control group (P=.026).
Dried salted plum consumption does not decrease the incidence of MEB, but may ameliorate the severity of first chamber session HBO₂-induced otalgia.
高压氧（HBO₂）治疗最常见的并发症之一是中耳气压伤（MEB），偶尔会引起耳痛。本研究的目的是评估食用咸梅干对MEB及与HBO₂治疗相关耳痛的影响。
本前瞻性随机对照试验纳入了接受首次HBO₂治疗舱内治疗的患者。所有患者在HBO₂治疗前均进行瓦尔萨尔瓦动作。患者被随机分为两组：一组在HBO₂治疗期间食用咸梅干，另一组不食用。HBO₂治疗后进行耳镜检查。根据蒂德评分对MEB进行分级。使用视觉模拟量表（VAS）记录耳痛程度。
共纳入90例患者。食用咸梅干的患者中MEB（蒂德评分14级）的总发生率为39.6%（53例中的21例），而对照组为37.8%（37例中的14例）（P = 1.000）。两组之间轻度MEB（蒂德评分12级）和重度MEB（蒂德评分3~4级）的发生率无显著差异。食用咸梅干的患者中有5.7%（53例中的3例）出现耳痛，而对照组为18.9%（37例中的7例）（P = 0.085）。食用咸梅干的患者中没有耳痛VAS评分≥4的患者，而对照组为10.8%（37例中的4例）（P = 0.026）。
食用咸梅干不会降低MEB的发生率，但可能会减轻首次舱内HBO₂治疗引起的耳痛严重程度。
