高空减压病诊断和治疗进展

目的 介绍国内外高空减压病(ADS)诊断和治疗进展情况,以期能对提高ADS临床处置水平有所帮助.资料来源与选择国内外该领域的相关文献.资料引用引用国内外参考文献26篇.资料综合减压病缺乏特异性的客观诊断指标,症状学表现仍是减压病诊断的主要依据,但不同要素的重要性不同.由于神经组织易产生原发性气泡,故静脉气泡尚不能作为预测神经型ADS的有效指标.对卵圆孔未闭在ADS发病中的作用值得临床航空医学工作者进行更多的研究.单纯连续呼吸纯氧对ADS的治疗有一定作用,但对实际作战飞行条件下发病者治疗效果的评价还需要慎重考虑.加压治疗方案的改进主要是考虑降低治疗压力和减少治疗时间.针对一些延迟治疗的病例,对现行的美国海军加压治疗方案尚需进一步完善.结论 虽然大多数ADS能够完全治愈,但由于一些延迟治疗的以及神经型ADS有可能遗留难治性的后遗症,因此在诊断和治疗方面仍需给予充分重视.造成ADS诊断技术停滞不前的主要原因是对ADS基础研究的缺乏,只有深入认识生物体内气泡生成和气泡引起一系列病理变化的细节才能为ADS的诊断和治疗提供更加有效的方法.

Progress in diagnosis and treatment of altitude decompression sickness

Objective To introduce the progress in diagnosis and treatment of altitude decompression sickness(ADS)home and abroad,in order to improve the level of clinical treatment of ADS.Literature resource and selection Related references in this field home and abroad.Literature quotation Twenty-six research papers and reviews were cited.Literature synthesis There is no peculiar objective diagnosis index of ADS.The ADS diagnosis is mainly based on symptoms,while the different symptom has the different importance.The nerve fiber is apt tO produce the original bubbles,so the vein gas bubble can't still be regarded as the effective index of predicting neural ADS.Patent foramen ovale is one of the susceptible factors to the occurrence of neurological ADS.BUt its exact role in ADS is worth carrying on more studies by the clinical aviation medical workers.Breathing pure oxygen continuously has certain effect on the treatment of ADS,but it needs appraising carefully the result of treatment for persons who have ADS under the actual flying condition.The main improvement of the hyperbaric oxygen(HBO)treatment scheme is reducing the treatment pressure and period.For some delayed therapy case,HBO pressurizing scheme still needs to be perfected furtherly. Conclusions Though most ADS can be totally cured,some cases may leave refractory sequelae because of the delay treating or neural ADS,so it still needs to pay full attention to diagnosing and treating of ADS.The main cause why ADS diagnosis technique stagnates is the shortage of ADS basic research.Only deeply understanding the detail about bubble formation and a series of pathology change that bubble causes in the organism may offer more effective method for diagnosis and treatment of ADS.