规范鼓室内注射操作 降低新型冠状病毒交叉感染风险

目的探讨如何规范、安全、有效地实施鼓室内注射操作,减少和防止药物从鼻部及口咽部溢出,避免新型冠状病毒(2019-nCoV)交叉感染风险,并尽可能降低鼓室内注射的不良反应。方法回顾分析耳内镜下(426例,共1278次)与普通额镜下(712例,共1928次)鼓针注射的患者资料,比较2组注射操作中耳痛、眩晕、穿孔等不良反应的发生率以及鼻部和口咽部药物溢出率的不同;分析耳内镜下长5号针鼓室内注射的2796例(共8948次,其中疫情期间注射223例,312次)及鼓针鼓室内注射的426例(共1278次)患者的临床资料,比较采用不同注射针头不良反应的发生情况。结果耳内镜组总不良反应率、鼻部和口咽部药物溢出率低于额镜组,2组差异有统计学意义。耳内镜下注射时,将鼓针更换为长5号针头后,患者眩晕发生率降低,疼痛减轻,鼓膜出血减少,2组差异有统计学意义。结论耳内镜下采用长5号针头行鼓室内注射可以减少操作的不良反应,降低鼻部和口咽部的药物溢出率,最大限度地避免2019-nCoV交叉感染的风险。

Suggestions for standardizing the process of intratympanic injection during the epidemic control of coronavirus disease 2019

Objective To explore how to perform intratympanic injection safely and efficiently,and how to reduce and prevent drug spillage in the nose and oropharynx to avoid the risk of cross-infection under the outbreak of the new coronavirus disease 2019.Methods A retrospective analysis of 426 cases(1278 shots)who underwent endoscopy and 712 cases(1928 shots)who underwent ordinary frontoscopy were performed.Adverse reactions incidence and the difference in nasal and oropharyngeal drug spillage rates were compared.The incidences of adverse reactions were compared between different needle groups:2796 cases(8948 shots in total,223 cases injected 312 shots during the epidemic)of endoscopic intratympanic injection with long 5 needle and 426 cases(1278 shots)with tympanic needle.Results The rates of both the adverse reactions and the pharyngeal drug spillage in the endoscope group were lower than those in the frontoscopy group,and the difference between the two groups were all statistically significant.When the intratympanic injection was performed under endoscope,after replacing the tympanic needle with a long 5 needle,the incidences of vertigo,pain,and tympanic membrane bleeding were all reduced.The differences between the two groups were all statistically significant.Conclusions Using the long needle injection to undergo the intratympanic injection under endoscopy can reduce the adverse reactions of the operation,and can reduce the rate of drug spillage in the nose and oropharynx,and can avoid the risk of cross-infection of the new coronavirus to the greatest extent.