懷孕婦女的九步驟灌氣放氣歐氏管功能測試

Nine Step Inflation-Deflation Eustachian Tube Function Test in Pregnant Women

邱國華(Kuo-Hua Chiu) ； 曹國桃(Gwo-Taur Tsaur) ； 楊南瑩(Nan-Yin Young)

《中華民國耳鼻喉科醫學雜誌》 34卷3期 (1999/05) Pp. 212-218

https://doi.org/10.6286/1999.34.3.212

摘要

背景：懷孕婦女常有鼻塞併耳悶感的抱怨，被認為可能因動情素或黃體素而造成歐氏管充血腫脹而阻塞。因隨懷孕過程而漸增的動情素是否影響歐氏管功能，國外文獻報告結果不一。因此本研究嘗試探討國內懷孕婦女的歐氏管功能變化及其與動情素、黃體素的關係。
方法：自婦產科門診收集38名無中耳疾患病史的孕婦，在懷孕第12、24及36週時分別採“九步驟灌氣放氣歐氏管功能測試”（nine-step inflation-deflation eustachian tube function test）來評估懷孕前、中、後期歐氏管功能並抽血測試動情素與黃體素濃度。另選36名健檢正常女性為對照組，以Cantekin之分類方法分析結果。並統計動情素、黃體素及體重增加量3者分別與歐氏管功能的相關性。同時並分別比較（1）懷孕前中期組、後期組和對照組及（2）懷孕前、中、後期3組歐氏管功能的差異。
結果：動情素、黃體素及體重增加量3者分別與中耳起始靜態壓力及歐氏管功能分類組別皆無統計上的相關性。懷孕後期組之起始靜態壓力平均值為-24.8 mm H2O，與對照組（72耳）之間有統計上的差異（p=0.004），至於3組間歐氏管功能分組皆無明顯差別。懷孕前中期組74.1%具歐氏管平衡能力與對照組75.0%接近，而與懷孕後期組55.0%有差距。懷孕前、中、後期3組間測試的中耳起始靜態壓力及歐氏管功能分組無明顯差別。歐氏管功能正常比率則依序漸減。
結論：懷孕後期之中耳起始靜態壓力比對照組更呈負壓。黃體素、動情素及體重增加量3者與孕婦的歐氏管功能無統計上的相關性。

關鍵字

九步驟灌氣放氣歐氏管功能測試 ； 懷孕

並列摘要

Background: Otolaryngologists are familiar with the symptoms of nasal obstruc-tion and ear stuffiness in pregnant women. It is possible that the eustachian tube is affected by changes in estrogen and progesterone levels. The aim of this study is to determine whether Eustachian tube function changes signifi-cantly during pregnancy, and to investigate its relationship with the levels of estrogen and progesterone.
Method: Thirty-eight pregnant women without previous middle ear disease participated in this study. The subjects underwent a nine-step inflation-defla-tion eustachian tube function test. Their serum estrogen and progesterone levels were recored in the 12th, 24th, and 36th weeks of gestation. The trimester I-II group (112 ears) comprised 76 ears of women in the 12th week of gestation and 36 ears of women in the 24th week of gestation, while the trimester III group comprised 20 ears of women in the 36th week of gesta-tion. The control group consisted of 72 ears of 36 non-pregnant women. The relationships between nine-step inflation-deflation Eustachian tube function and estrogen level, progesterone level, and weight gain were analyzed sepa-rately. According to Cantekin’s categories, the Eustachian tube function of these subjects were grouped into five categories.
Result: Estrogen level, progesterone level, and weight gain were not correlated with resting middle ear pressure (T1) or Eustachian tube functions of various groups. The average T1 value was -24.8 mm H2O in the trimester III group, which was significantly lower than -8.5 mm H2O in the control group (Studentt-test, p=0.004). The differences in the functional grouping among the trimester I-II, trimester III, and control groups were not statistically significant. According to Cantekin’s categories, 74.1% of the ears in the trimester I-II group manifested normal tubal function, similar to the results in the control group, whereas only 55.0% of the ears in the trimester III group had normal function. The T1 and the eustachian tube functions of various groups did not differ significantly among ears of women in the 12th, 24th, and 36th weeks of gestantion.
Conclusion: The average T1 in pregnant women in the third trimester was signif-icantly lower than that in the control group. Tube function during pregnancy had no correlation with the estrogen level, progesterone level, or gain in body weight.

並列關鍵字

nine-step inflation-deflation eustachian tube function test ； pregnancy