教你怎 么把儿童耳内的异物取出.doc 5页VIP

教你怎么把儿童耳内的异物取出 　近日有媒体报道，一名女童的耳朵飘进花种并生根发芽，4个月后耳朵里长出蒲公英。对此首都儿科研究所耳鼻喉科主任医师谷庆隆表示，孩子耳内存在 异物的情况比较常见，容易被人忽视，家长应充分重视。若取物方法不当，容易造成耳内感染甚至引发其他更多的并发症，严重可能导致鼓膜划伤甚至破裂，进而引 起孩子听力障碍。 　　儿童耳内进异物多发 　　谷庆隆医生表示，门诊中孩子耳内进异物的情况非常多见。由于孩子好奇心重，耳道内的异物往往都是自己塞进去的。“有的孩子喜欢玩互相往耳朵塞东西的游戏。小玩具、豆子、小钉子、小石子等都见到过，这些东西塞进去后很容易发现，但有些耳内异物还是容易被忽视。” 　　谷医生分析了儿童耳朵易进异物的原因，首先这和孩子的生活习惯及其生长发育特点有关。孩子的好奇心比较强，而感知比较差，他没法准确判断自己的行为是否存在危险，有意或无意中就把自己喜欢的东西塞进耳朵了。 　　其次，大多数耳道的异物，往往给人体造成不适感不是很强烈，这也容易被孩子忽略。时间久了，孩子便习惯了这类异物的存在，这就容易为异物损伤耳朵埋下隐患。 　　耳道构造分为外耳道、中耳和内耳，异物一般在外耳道。据谷医生介绍，“耳道是一条自外耳门至鼓膜的弯曲管道，这是人体的自我保护机制之一。管道弯曲处比较狭窄，那么较大的异物就会卡在弯口，但较小的异物则可能进入内耳道甚至直达鼓膜。” 　　门 诊中比较常见的耳内异物大体上分为动物类、植物类和金属塑料类等。其中以耳朵进小虫子、蟑螂或者其他圆滑颗粒物等情况居多。谷庆隆医生表示，当耳内进入虫 子等异物时，患儿会有明显的不适感，虫子在动时能感觉到有不规则的响声。“小虫子可能会自己爬出来，但大虫子由于不能后退往往会滞留在里面。时间一长虫子 就有可能死在耳道内，就会散发出臭味，还可能淌脓水，进而造成耳内感染甚至引发其他更多的并发症。 　　夏天虫子多，耳内异物就诊的患者更多。谷医生指出，“昆虫类义务对孩子的刺激是较大的，小虫子锋利的爪子敲打鼓膜，导致异常的响动没会引起孩子异常的恐惧。 　　据 介绍，鼓膜是一层灰白色半透明薄膜，将外耳道与中耳隔开。正常情况下，鼓膜能感应由外耳道传入的声波，产生振动并牵动附于其上的听小骨链，使声波的刺激传 进中耳。在整个听觉传导路径中，鼓膜算是起始的其中一站，即使鼓膜完全缺损，我们仍能听得到，只是由于传入的声波减弱，会使听力减弱。 　　耳中异物“取之有方” 　　门诊中，谷庆隆也遇到不少耳道划伤的患儿，往往是因为家长先前使用方法不当所导致的。“实际上孩子耳道中的很多异物，若第一时间就去正规医院找专业医生取的话，是不需要通过全麻住院来取的。” 　　据 谷医生介绍，有的孩子来医院看诊时因为先前的不正常取出，导致耳道皮肤红肿引发外耳道炎，轻轻一碰，耳朵就疼得厉害。这时候，孩子往往不太配合医生。外耳 道发炎的特点是牵拉耳道疼痛明显，如果耳道肿胀明显可能会引起短期听力下降，但是异物取出来之后，炎症消退便可恢复。但若鼓膜划伤或破裂，且不能恢复，可 能会引起孩子的听力障碍。 　　谷庆隆医生建议，如果进入耳内的是比较圆滑的东西，且接近外耳道的入口，在孩子配合的情况下，家长可以用镊子、挖耳勺等将异物取出，如果是尖锐的东西则需要到医院就诊。 　　谷庆隆医生建议家长，“若孩子耳朵进了蟑螂等，家长切忌用手去拽。因为蟑螂等生物有爪子，若它受到外界的刺激，会拼命往里抓，可能会造成耳道损伤。” 　　如 果钻入耳朵内的是虫子，可以先在耳朵内滴上一些植物油，填满耳道即可。这样可以将耳内的虫子淹死，或者滴1至2滴干净的婴儿油、沙拉油、酒精，虫就会窒息 而死，然后把耳朵朝下，虫会连同油流出。随后则要到医院就医，将虫子取出，进行必要的清理。另外，家长还可用光线照射耳朵，因为虫子具有向光性，可利用光 线，将虫子诱出，以手电筒朝耳朵内道口照射即可。 　　此外谷庆隆强调，孩子耳朵若进了豆类等，千万不要用水冲洗，因为豆类遇水膨胀会刺激外耳道皮肤，导致发炎和感染，有时会有剧烈的疼痛。 　　疑难异物应及时求医 　　谷 庆隆医生指出，家长要做到及早发现孩子耳内的异物，第一要关注孩子平时是否有喜欢往耳朵塞东西的行为倾向；第二家长应注意观察孩子的症状。“如果孩子之前 往耳朵里塞过东西，家长就要保持一定的警惕。若孩子表示耳朵不舒服或老抓耳朵或，那就有存在问题的可能性，此时最好带孩子上医院看诊。” 　　谷 庆隆给家长提出如下几点建议：首先，家长最好不要自行掏取异物。因为人的外耳道是S形的，内部有狭窄区域，若自取方法不当，一方面可能把异物尤其是球形异 物越捅越深，另一方面容易引起外耳道炎，有时这种炎症很难控制，而且会破坏外耳道的自洁功能。此外，自行掏取异物容易损伤外耳道皮肤引发感染，甚至导致耳 膜穿孔。一旦耳朵被掏伤，伴有血迹，则应立即到医院就诊。 　　其次，要选择去正规医院的耳鼻咽喉科就诊，请医生观察孩子的外耳道。如果孩子耳朵的确有异物，则请有经验的医生取出。“一般来说，医院都会有一个应急流程，家长可挂急诊，不用排队。” 　　谷医生介绍，若异物在耳道里时间较长，就要看异物是否损伤到耳道周围皮肤，是否损伤鼓膜。“此时我们会通过耳内窥镜检查，若异物对耳朵造成的损伤较大，则要拍CT来实现进一步诊断。” 谷 庆隆建议，首先家长应了解孩子各生长关键期的特点，婴幼儿家长要合理管理儿童所能触及的物品，如留意玩具使用的年龄段，以确定它是否适合自己的孩子使用； 其次，家长对孩子的教育很重要。家长应培养孩子良好的生活习惯，树立其对物品的正确认知，如教育孩子不能向耳朵内乱塞东西，从日常生活中规范孩子的行为。 Recent media reports, a girls ears float into the flower seeds and sprout, 4 months later there a dandelion in the ear. The capital institute of pediatric otolaryngology chief physician GuQingLong, said children there is foreign body inside is more common, easy to miss, parents should take seriously. If the fetch method is undeserved, can cause ear infections and even more complications, serious can lead to tympanic membrane cut even burst, and then bring up children hearing impairment. Childrens ears into foreign body happens GuQingLong doctor said, in the outpatient children into foreign body inside is very rare. Because children curiosity is heavy, in the ear canal foreign body tend to be in himself. Some children like to play with each other to the ears of the game. Small toys, beans, small nails, such as small stones are seen, it is easy to find, after these things in but some foreign matter or overlooked ears. Valley doctors analyzed the cause of childrens ears easily into the foreign body, first of all the children and living habits and its growth and development characteristics. Children curiosity is strong, and awareness is poor, he couldnt accurately judge whether their behavior is dangerous, intentionally or unintentionally put their favorite things into the ear. Second, most of the ear canal foreign body, often cause discomfort to the body is not very strong, it also easily ignored by a child. Time is long, the child was accustomed to the existence of such a foreign body, it is easy for foreign object damage the ear. Ear structure was divided into external auditory canal and middle ear and inner ear, foreign bodies in external auditory canal. According to doctors valley, the ear canal is a pipeline from step to tympanic membrane bending, this is one of the bodys self protection mechanism. The pipe bend is narrow, the larger foreign bodies will card in the mouth, but smaller foreign bodies may be into the inner ear and even to the tympanic membrane. Door diagnosis are common in the ears of a foreign body can be broadly divided into animal, plant and metal plastic, etc. Of which goes in bugs, cockroaches or other smooth particles, and so on and so forth. GuQingLong said the doctor, when the ear into the insect son, foreign bodies, children will have obvious discomfort, insects can feel with the irregular noise when moving. Bugs can climb out, but the big worms unable to retreat tend to be trapped in it. A long time, the worm will likely to die within the ear canal, will send out a stink, may also ichor dripped, thus cause ear infections and even more complications. Summer insects, ear patients more foreign body treatment. Valley, said the doctor, insects obligations to the childs stimulus is bigger, tapping eardrum bugs sharp claws, result in abnormal noise didnt cause the child abnormal fear. According to introducing, tympanic membrane is a layer of pale translucent membrane, separated from the external auditory canal and middle ear. Under normal circumstances, the eardrum can induced by the plane of the incoming sound waves and vibrations and affects on its ear bone on the chain, make acoustic stimulus into the middle ear. Throughout the auditory transduction pathway, tympanic membrane is starting one of the station, even tympanic membrane defects completely, we can still hear, just because of the incoming sound waves is abate, can make the hearing. Ears eyewinker get well Outpatient service, has also had quite a few children with ear scratch GuQingLong, often because their parents had caused by improper usage. In fact the many foreign body in children ear canal, if go to normal hospital for doctors to look professional to take, dont need through to the general hospital. According to doctors valley, when some children to the hospital diagnosis because the previous abnormal taken out, cause ear skin irritation caused by otitis externa, gently touched, ear pain is very severe. At that time, children often dont cooperate with the doctor. The characteristics of the outer ear inflammation is to pull the ear pain obviously, if the ear swelling may cause short term hearing loss, but, after the foreign bodies to inflammation subsidise can be restored. But if the eardrum scratch or broken, and cant recover, may cause the childs hearing impairment. GuQingLong doctor advised, if enter the ear is relatively smooth, and close to the entrance of the external auditory canal, in the case of children with, parents can use tweezers, dig earwax spoon remove foreign bodies, such as if it is sharp things you need to the hospital. GuQingLong doctors suggest parents, if a child goes in the cockroaches, parents dont with the hand to pull. Because cockroaches and other creatures with claws, if the stimulation of it from the outside world, will be hard to grasp, can cause ear injury. If go inside the ear is the worm, which can be first on the ear drops some vegetable oil, fill in the ear canal. This can be the insect ears drowned, or 1 to 2 drops clean baby oil, salad oil, alcohol, worm will be choked to death, and then put its ears, worm will along with the oil flow out. Then want to go to the hospital for medical treatment, remove the worms, necessary cleaning. In addition, parents also available light ears because worms have phototropism, available light line, throw out, with a flashlight in the ears crossing irradiation. In addition GuQingLong stressed that if a childs ear into the beans, etc., dont flush, because beans in water can stimulate the outer skin, cause inflammation and infection, sometimes has a severe pain. Difficult foreign bodies should seek treatment in a timely manner Valley city, he pointed out that the parents to do early detection the foreign body inside the ear, the first to focus on whether children usually like to ear plug things behavior; The parents should observe the childs symptoms. If the children before anything in his ears, parents should maintain vigilance. If a child says ears uncomfortable or old catch ear or that there is the possibility of problems, children at this point the best on the hospital. Valley city long for parents to put forward the following Suggestions: first, the parents had better not to take out foreign body. Because of the external auditory canal is s-shaped, with narrow area, if result in improper way, on the one hand, the foreign body may be especially spherical vision tong ever deeper, on the other hand, easy to cause otitis externa, sometimes its hard to control inflammation, and will destroy the self-cleaning function of the external auditory canal. In addition, to take out foreign body easy to damage the outer skin infection, and even lead to ear membrane perforation. Once the ear is tao, accompanied by blood, should go to hospital immediately. Secondly, should choose to go to normal hospital otolaryngology doctor, please observe the childs doctor external auditory canal. If the child ears do have foreign body, the experienced doctors take out, please. In general, the hospital will have a emergency process, parents can hang the emergency, dont line up. Doctors valley if foreign body in the