寒区海军部队潜水员冬季加压锻炼意义初探

目的巩固和提高寒区海军部队潜水员冬季对高气压环境的适应性和耐受力,有效完成各种潜水任务.方法 加压锻炼压力为0.3～0.4 MPa,停留时间50 min或40 min,均需按有关表上规定执行,隔日1次.锻炼后,分析潜水员的身体状况和对高压的适应情况.结果加压锻炼可以有效增强潜水员的体质和对高压环境的适应性.结论冬季加压锻炼能保证潜水员随时适应水下高气压作业环境,有效预防潜水疾病的发生.     

超声气泡检测在潜水减压研究中的应用

即使没有违背减压方案,潜水减压结束后潜水员体内也会产生气泡,发生静脉气体栓塞.由于气泡数量少或这些气泡尚未造成明显的减压病症状和体征,大部分情况下潜水员并未感觉存在静脉气体栓塞.然而,减压后体内气泡的数量、部位、持续时间等与潜水后减压病的发生风险有关,越来越多的研究通过检测潜水减压后体内气泡的相关参数来评估减压应激程度和减压病的发生风险.本文就超声气泡检测方法在潜水减压研究中的应用进行综述.     

当前潜水生理学与医学发展的几个问题

<正> 潜水生理学和医学是研究人体暴露于水下环境和高气压条件下生命活动规律的科学。其研究目的是保证人体能顺利的潜入到海洋深处,进行有效的活动,再安全返回水面,遇到疾病时又能予以及时治疗,其研究成果可为潜水员的选拔和培训,为潜水过程制定适宜的加压方案,合理混合气的配比、     

100m氦氧饱和112m氦氧巡回潜水的医务保障

4名海军潜水员在DDC内1.0MPa氦氧饱和条件下暴露72h,此间他们分批经SDC到海底巡潜,最大深度到达112m。饱和潜水期间,DDC内氧分压控制在40kPa,氮分压低于136kPa,氦分压为925kPa,二氧化碳分压小于10kPa。SDC内氧分压为45kPa,二氧化碳分压控制在lkPa以内。巡潜时,潜水员呼吸氧分压为110kPa的氦氧混合气。减压采用适当修正后的英国饱和潜水减压表中有关方案完成。在潜水现场条件较差的情况下,未发生高压神经综合征、减压病、氧中毒及其他潜水疾病;除晕船外,潜水员生理状况和主观感觉良好,顺利完成了各项水下操作任务。     

潜水员海水淹溺1例

某潜水员在某海域使用MZ-300潜水装具进行水下铺设石油管线作业,由于对该装具使用不熟悉,供气余压过低、管路过细,着装时头带未拉紧,导致面罩松动进水,进水后潜水员没有正确操作自由流阀,导致海水淹溺。将其抢救出水后,送入加压舱进行预防性加压治疗,治愈出院,随防至今未发现后遗症。现报告如下。     

潜水相关耳鼻喉医学问题

随着社会的发展，潜水已经成为一种越来越受欢迎的休闲活动。研究显示，大部分的潜水员，都经历过潜水相关的耳、鼻、喉症状，早期正确诊断和治疗，有助于疾病的缓解，帮助潜水员尽快重返潜水活动。本文对潜水相关的耳、鼻、喉疾病进行全面的介绍，以期为相关疾病的诊断和治疗提供有益的借鉴。     

兼职潜水员轻潜水训练的实施与医学保障

目的 完善兼职潜水员着69-3型潜水装具轻潜水训练的实施与医学保障.方法 36名兼职潜水员先理论后实践、由浅入深地进行潜水训练.在人员选拔、潜水训练、海上实作中进行医学保障.结果 潜水训练顺利完成,未出现氧中毒、气压伤、溺水等潜水疾病,兼职潜水员心理素质较好.结论 科学合理的施训方法和有效的医学保障是完成兼职潜水员轻潜...     

模拟潜水加压锻炼致减压性关节痛1例报告

患者,男性,23岁,职业潜水员,因工作需要每周进行模拟潜水加压锻炼1次,暴露压力均为3kgf／cm^2（表压）,加压锻炼采用我国60米水下空气潜水减压表,以1kgf／cm^2·min速率加压至3kgf／cm^2,在此深度停留40min,然后分别于0．9kgf／cm^2、0．6kgf／cm^2、0．3kgf／cm^2深各停留4min、10min、12min;减压总时间为32min,整个过程历时75min。该次加压潜水员感觉良好,无任何不适,历时1h 15min,顺利完成加压出舱。8min后该潜水员因内急如厕,     

规范潜水军医培训，增强潜水安全保障

潜水部队是我海军的重要技术兵种之一，军事潜水急难险重，潜水员的水下作业安全至关重要。潜水军医担负着潜水作业医学保障的重任，各国海军都十分重视潜水军医的培养和管理。我军拥有庞大的潜水员队伍，需要大量高素质的潜水军医保障作业安全^[1]。然而，我军在潜水军医的培养和任职管理方面还存在诸多问题，有待进一步完善。     

潜水员呼吸阻力调节装置的研制

呼吸阻力是潜水过程中导致潜水员负荷加重的主要原因之一。一般潜水员在水下依赖改变呼吸方式适应呼吸阻力的变化以保证呼吸流量。呼吸阻力也是个人呼吸防护装置的重要评价指标。潜水呼吸器作为个人水下呼吸保护装置,目前尚无有人实验检测呼吸阻力的数据背景资料,并且在高压下进行不同呼吸阻力下潜水员呼吸训练的合适装置。为研究潜水呼吸器的呼吸阻力,从而对潜水员的作业能力作出评价,需要在常压和高压下改变呼气和吸气阻力。为     

Diving accidents treated at a military hospital-based recompression chamber facility in Peninsular Malaysia

This paper describes the pattern of diving accidents treated in a military hospital-based recompression chamber facility in Peninsular Malaysia. A retrospective study was carried out to utilize secondary data from the respective hospital medical records from 1st January 1996 to 31st December 2004. A total of 179 cases categorized as diving accidents received treatment with an average of 20 cases per year. Out of 179 cases, 96.3% (n = 173) received recompression treatment. Majority were males (93.3%), civilians (87.2%) and non-Malaysian citizens (59.2%). Commercial diving activities contributed the highest percentage of diving accidents (48.0%), followed by recreational (39.2%) and military (12.8%). Diving accidents due to commercial diving (n = 86) were mainly contributed by underwater logging activities (87.2%). The most common cases sustained were decompression illness (DCI) (96.1%). Underwater logging and recreational diving activities which contribute to a significant number of diving accidents must be closely monitored. Notification, centralised data registration, medical surveillance as well as legislations related to diving activities in Malaysia are essential to ensure adequate monitoring of diving accidents in the future.     

扩血管与加压治疗对神经系统减压病疗效的临床分析

目的:探讨减压病的发病机理及治疗方案.方法:将60例神经系统减压病的患者随机分为2组:A组28例接受氟桂利嗪和加压治疗,B组32例只接受加压治疗.另收集未进行加压治疗的神经系统减压病患者36例作为比较,其中病初使用扩血管药物的20例为C组,未使用扩血管药物的16例为D组.采用欧洲卒中量表(ESS),Barthel指数(BI)评价神经功能恢复状况.结果:扩血管治疗组ESS分数迅速增加,组间(A组与B组,C组与D组)差异有统计学意义.结论:血管痉挛可能是减压病的重要病因之一,因而扩血管治疗对神经系统减压病有效.     

大鼠急性减压病时脊髓诱发电位的变化

实验观察在电刺激大鼠双侧坐骨神经而诱发的脊髓诱发电位(SEP)在常压下、高压下、不当快速减压后(重型减压病时)、安全减压后、再加压后和常压下急性缺氧等条件下的变化。SEP变化与减压病(DCS)发生有关。在时间上SEP晚期成分先于早期成分变化。用SEP作DCS动态监测时晚期成分较早期成分敏感,且以观察振幅为主。一旦晚期成分有所变化即应对DCS的发生给予高度重视,此时再加压可使DCS缓解或消除。当早期成分变化时,DCS的严重程度已可使动物死亡,即使再加压亦无效。因此,SEP早、晚期成分在反映DCS严重程度上有质的区别,其中尤以N_2波变化为关键。     

Changes of Spinal Evoked Potentials in Acute Decompress ion Sickness of Rats

Changes of spinal evoked potentials (SEP) were observed in rats by stimulatingthe sciatic nerves on both sides under various pressure conditions (normal,hyperbaric,rapid decompression,safe decompression,and recompression treatment) and in acuteanoxia.It was observed that occurence of acute decompression sickhess (DCS) was relatedwith changes of SEP.The changes of SEP late components (N_3,P_3,N_2) occurred earlierthan SEP early components (P_2,N_1,P_4).It was shown that in using SEP method tomonitor DCS,late components were more sensitive as compared with early components andspecial attention should be given to the amplitudes of SEP.As soon as changes of latecomponents appeared,acute DCS would follow.If recompression would be given at thispoint,DCS could be reduced or eliminated.When early components showed changes,DCSwas in such a stage as to cause immediate death of the animals.Recompression had noeffects at this point.The late components and early components,therefore,were ofsignificantly different value in reflecting the level of DCS.N_2 wave was an important key.The results suggest that using the SEP method to monitor acute DCS is a sensitive andaccurate way.     

Decompression illness associated with underwater logging: 6 case reports from Kenyir Lake, Malaysia

The formation of Kenyir Lake as part of a hydroelectric project in the 1980s caused much forest area to be submerged. From 1991, underwater divers were employed to log these sunken trees at depths of up to 100 meters. At least 6 mishaps involving underwater logging personnel were recorded from March 1994 to August 1996. We retrospectively reviewed 5 cases who were managed in Hospital Kuala Terengganu. The patients presented with marked cardiorespiratory and neurological disturbances. One diver died in the Hospital while another died at the recompression chamber. Three divers were treated with recompression and improved. Average delay before the start of recompression was 14 hours. Underwater logging has definite dangers and steps must be taken to ensure that both the divers and the equipment are appropriate for the task. Availability of a nearby recompression facility would greatly enhance the management of diving accidents, not only for commercial divers but also for recreational divers who frequent the islands nearby.     

The development of hyperbaric and diving medicine in Singapore

Hyperbaric oxygen therapy is a noninvasive therapy used in the treatment of diving-related medical illnesses. It is an important adjunct in the management of a variety of medical conditions. The Republic of Singapore Navy Medical Service (NMS) is the main driver of the development of hyperbaric and diving medicine in Singapore. The practice of hyperbaric medicine has inherent risks, and unregulated application of this therapy may do more harm than good. NMS and Singapore General Hospital (SGH) signed a Memorandum of Understanding to combine NMS' experience with the clinical expertise of SGH to provide holistic care for diving and clinical hyperbaric treatment patients. This collaboration would increase the profile of this clinical specialty in Singapore, and help to establish safe clinical practice guidelines, training and accreditation requirements for diving and hyperbaric medicine practitioners in Singapore, thus ensuring that the practice of bona fide hyperbaric medicine is safeguarded and patient care is not compromised.     

高压氧治疗潜水捕捞致减压病56例疗效分析

目的探讨高压氧治疗潜水捕捞致减压病的疗效。方法回顾性分析我科2011年7-9月间采用高压氧加压综合治疗56例潜水捕捞致减压病患者的临床资料。结果56例患者均采用高压氧加压综合治疗,其中痊愈32例（56％）,好转23例（42％）,无效1例（2％）。结论高压氧加压对潜水捕捞致减压病疗效确切,值得推广。     

氦氧混合气在医学实践中的应用

氦氧混合气具有独特的理化特性，不仅可作为呼吸气体用于潜水作业，还在哮喘、慢性阻塞性肺疾病、减压病等多种疾病的治疗和预防中展现出良好的效果。随着更多理化效应被发现，相关应用还在持续扩展。本文对氦氧混合气在医学实践中的应用进行综述，为后续更多拓展提供借鉴。     

计算机监控的实时减压方法探讨

实时减压是一种适于水下历程多变时的减压技术,本文介绍了一种以串联模型为基础的数学模型和算法,并以美、苏空气潜水减压表为依据进一步修正后,用以指导减压。在加压舱内25～45m 深度下进行了26人次的可变深度潜水和反复潜水,水下总时间为2～3h。多普勒超声监测表明,多数方案可做到无气泡的安全减压。仅1人出现过肘关节的不适,迅速自愈。结果表明,在实验室条件下,本方法体现出一定的优越性。