RELATIONSHIP BETWEEN STATE OF TRNAMUCOSAL GAS EXCHANGE AND

本文报告了70例中耳粘膜病变对中耳腔存在跨粘膜气体交换功能的影响，并用鼓室通气管置入中耳炎(OME)患儿，经OME治疗后，该功能恢复。为了阐明引起跨粘膜气体交换功能改变的原因，用正常成年新西兰大白兔观察了中耳总压(METP)、粘膜血流量和组织病理学改变。本实验表明，METP是中耳腔与粘膜血管之间气体交换的结果，且METP取决于血管内血流的程度。此外，这种血流量还与粘膜的炎症变化程度有关。在我们的临床研究中，当粘膜发炎时，跨粘膜气体交换功能严重中断，而在TUBE取出术时METP低的患者中耳炎复发的发生率增加。根据这些事实，METP的变化反映了中耳黏膜的状态，从而为OME的治疗提供了重要的诊断信息。

We reported that the transmucosal gas exchange function existed in the middle ear cavity and this function was effected by the seventy of middle ear mucosal lesions, employing children with otitis media with efiusion (OME) to whom we had inserted a tympanic ventilation tube (TUBE), and this function was recovered by the treatment of OME. Tb elucidate what causes changes in the transmucosal gas exchange function, normal adults New Zealand White rabbits were used to investigate the change in the middle ear total pressure (METP), the blood flow and the histopathological change in the mucous membrane. The present experiments in rabbits have shown that the METP is a result of gas exchange between the middle ear cavity and the mucosal vessels and the METP depend on the degree of blood flow in the vessels. Also this blood flow is related to the degree of inflammatory change of mucosa. In our clinical study, when the mucosaj is inflamed, the transmucosal gas exchange function is severely disrupted, while the incidence of recurrence of otitis media is increased in patients with a low METP at the time of removal of TUBE.Based on these facts, it can be concluded that changes m the METP reflect the state of the middle ear mucosa and thus represent important diagnostic information for use in the treatment of patients with OME.