近海石油平台作业人员心电图十年追踪观察

为了解和掌握近海石油平台作业对作业人员心功能的影响,我科有针对性地对467名海上作业人员进行了10年心电图动态追踪观察.分析和研究此类人员的心电图变化规律,为保障海上作业人员的身体健康和采取防治措施提供资料.现报告如下.     

1628例近海作业人员原发性高血压发病情况和干预对策

原发性高血压是航海人员的常见病,且呈上升趋势.“近海”一般认为船只在国内两个港口或国内至东南亚某港口之间的航程,一般一次航行时间在一昼夜以内.近海作业人员为近海客、货、渔轮船上以及近海海上工程、钻井平台上的工作人员,包括水手、轮机工、捕捞技工、工程技术人员及海上管理和服务人员等.因其生活、工作绝大部分时间都在船上或在钻井平台上,故有职业的特殊性,其职业特点又与常年漂泊海上的远洋船员有区别.     

近海石油平台作业人员外伤的院前急救探讨

由于海上作业的高危环境,平台上活动与工作场所缓冲地带窄小,机械设备繁多而且极为复杂,故近海石油平台作业人员,易受伤且常具有突然性.本文将1984年7月至2004年12月,由平台转送医院治疗的外伤患者88例进行回顾性分析.现报告如下.     

上海地区海域船舶人员高血压危险因素分析

目的　了解船舶人员高血压发病情况及危险因素 ,以指导防治。方法　对 1997年高血压普查资料行初步整理 ,并着重对高血压危险因素行 logistic回归分析。结果　高血压患病率为 6 .3%。危险因素有年龄、超体重、父系家族史、海上工作年限、职别及行政管理工作。结论　本调查确定的高血压危险因素与全国抽查结果相符 ;父系家族史对男性子代有遗传优势 ;可通过体育锻炼减少高血压发病。     

561名近海石油作业人员精神健康调查

目的　探讨近海石油作业人员社会心理因素与作业人员精神健康的关系。方法　采用横断面设计 ,自填式问卷 ,对 5 6 1名海上平台作业人员进行调查。调查内容包括 :职业紧张 ,A型行为性格 ,社会支持 ,应对措施和精神健康状况 (用 GHQ- 12测量 )。结果　 5 6 1人的 GHQ平均得分为 [10 .17±4 .97(0～ 34) ]分。按 GHQ- 12判别标准 ,16 5人 (2 9.4 % )被确认为“精神状况差”。控制年龄、文化程度、婚姻状况、海上工作年限和工种潜在混杂因素后 ,L ogistic回归分析表明 :“精神状况差”的危险因素是“没有耐心 /难于控制”趋向于 A型行为性格 ,并感受以下 7个与近海石油生产有较高关系的职业紧张因子。这 7个职业紧张因子是“工作与家庭 /社会生活”、“仕途与成就”、“人身安全感”、“工作中的管理问题及同事间的关系”、“工作环境中的物理因素”、“人体工效因素”和“组织结构”。结论　降低或消除工作中的职业紧张因素有利于促进近海石油作业人员的精神健康     

港口与海上作业人员颜面外伤163例临床分析

港口与海上作业人员颜面外伤１６３例临床分析王淑清颜面外伤是海洋工程和海上捕捞作业时的多发病，我科自１９８０年到１９９５年间共收治本地区港口与海上作业工人、以及渔民等颜面外伤患者１６３例，分析报告如下。一、临床资料１．一般资料：１６３例均为男性患者。年...     

海上作业人员急性会厌炎65例救治体会

海上作业人员以船、平台为单位散居于海上，由于海上气候变化较大，易患呼吸道疾病，如治疗不及时，常引起急性会厌炎和并发上呼吸道梗阻，造成窒息而危及生命。现将１９８７年以来接治此症患者共６５例总结报告如下。一、临床资料１．一般资料：６５例中男５９例，女６例...     

南海石油职工脂肪肝患病情况调查

脂肪肝是机体代谢紊乱、营养失调、长期酗酒、慢性感染等引起的肝脏组织脂肪变性，是危害人体健康的重要肝病之一，重者可演变成肝硬变（可达１０％）［１～３］。南海石油公司是从事海上石油、天然气勘探、开发的生产单位，专业特殊，尤其是海上平台作业人员，其饮食结构...     

美军战术战伤救治对海上自救互救的启示CSCD

现代海战中,舰船一旦被击中,可瞬时产生大量伤情复杂的伤员,同时,海上医疗伴随保障和支援保障困难,因此,提高一线人员自救互救能力具有重要意义。海上自救互救是指战（现）场一线人员自己或相互间用制式或其他简便器材对伤情进行的急救操作,目的在于降低阵亡率、伤死率和伤残率,是海战场伤员救治的起始。目前我军具有相对成熟的海上自救互救工作体制,但随着海上作战样式与减员的不断变化,逐渐暴露出较多的问题,     

我国北方海域船舶作业人员高血压患病率调查

目的　调查我国北方海域水面船舶作业人员高血压患病率 ,并与不同区域及一般人群高血压患病率比较。方法　对北方海域船舶作业人员按统一标准测量血压。结果　 (1)本组调查人员的高血压总患病率为 10 .36 % ,显著低于 1991年全国血压抽样调查男性患病率 (14.38% ) ,两者有非常显著差异 (P<0 .0 1) ;(2 )高血压总患病率显著高于同属北方的北京地区男性 ,且相应年龄组高血压患病率均显著高于全国的患病率 (P<0 .0 0 1) ;(3)本海域水下作业人员的高血压患病率显著高于热带海域水下作业人员的发病率 (P<0 .0 1)。结论　北方海域水面作业人员高血压患病率与同一地区的其他人群不同 ;同时 ,同样作业人群在不同地区的患病率有所不同 ,应予以重视。     

Established and recently identified coronary heart disease risk factors in young people: the influence of physical activity and physical fitness

Epidemiological studies have identified several risk factors for coronary heart disease (CHD), many of which are present in young people. [For the purpose of this review, the phrase "young people" embraces both children and adolescents.] One such risk factor is hypertension. In adults, exercise is thought to have a positive effect on blood pressure levels; however, findings are inconclusive for young people. Despite its association with CHD, obesity is on the increase in Western society's young population; prevention and intervention during early years is needed. An active lifestyle is considered to have a beneficial effect on body fatness. Lipoprotein profiles are directly associated with CHD status. In adults, there is some evidence that physical activity and/or fitness have a favourable effect on lipoprotein levels. Although information regarding the younger population is more ambiguous, it tends to concur with these findings. High levels of lipoprotein(a), are considered an independent risk factor for CHD. Relatively little has been written on young people, although some studies have postulated a favourable relationship with physical activity.An inverse relationship between aerobic fitness and CHD has been confirmed in adults; an association is not as easily verified for young people. Physical activity is similarly deemed to have a beneficial effect on health status. A high-fat diet has been linked to CHD in adults, and evidence to date reports similar findings for young people. Smoking increases the risk of CHD and even moderate smoking during youth could have damaging long-term consequences. There is some evidence that smoking is related to physical activity and fitness levels in young people.In adults, high levels of homocyst(e)ine have been associated with CHD. As yet, little has been written on the relationship between physical activity or physical fitness and homocysteine status in young people. High levels of plasma fibrinogen have been linked to CHD. Several studies have explored the relationship between plasma fibrinogen and physical activity and/or fitness in adults, but findings are inconclusive; for young people, the ambiguity is even greater. C-reactive protein is a molecular marker for CHD but, to date, little attention has been given to this aspect, especially amongst young people. The link between high levels of plasminogen activator inhibitor-1 and CHD has been confirmed, although the essence of this relationship is not established. There is a paucity of data on the younger population and the relevance of collating such information is questionable.For the younger population, most research is limited to the established CHD risk factors and further investigations of recently identified CHD risk factors are needed.     

飞行人员代谢综合征危险因素调查分析

目的探讨代谢综合征（metabolic syndrome,MS）发病危险因素对现役飞行人员的影响,提供防治策略。方法测量682例飞行人员体质指数（BMI）、血压、血甘油三酯（TG）、空腹血糖（FPG）等指标,以BMI≥25kg／m^2、血压≥140／90mmHg、TG≥1．7mmol／I。FPG≥6．1mmol／L为异常,上述指标≥3项异常者诊断为MS;比较七述指标在小州年龄组之间的差异;查阅受检者过去健康档案,观察上述指标的动态变化。结果682例飞行人员中共检出MS44例,发病率为6．45％。30岁以下飞行人员未榆出MS患者;31～40岁组发病率为4．73％,41～50岁组发病率为18．99％,51岁以上发病率为25．00％。奉组飞行人员中高BMI、高TG血症、高血压、高FPG异常率分别为39．44％、22．29％、8．21％、1．61％;其中l项代驸指标异常者205例（30．06％）,2项指标异常者72例（10．56％）,3项指标异常者43例（6．30％）,4项指标异常者1例（0．15％）,共累及321人,总检出率47．07％。结论MS已成为影响飞行人员身体健康的重要疾病。超重、高脂血症、年龄增长是MS发病的主要危险因素,应引起足够重视。     

The effects of exercise on coronary heart disease risk factors in children

Coronary heart disease (CHD) is now recognised as a paediatric problem despite the fact that clinical symptoms of this disease do not become apparent until much later in life. Epidemiological studies of risk factors in children have now been conducted. These studies suggest that the risk factors for cardiovascular disease in adults, which include a family history of heart disease, elevated blood lipids (serum cholesterol and triglycerides), obesity, hypertension, smoking, diabetes mellitus and inadequate physical activity, can be identified in children. Several investigators have reported the existence of one or more risk factors in more than 50% of the children they have examined. It is now clear that we can detect most children who are potentially at risk for CHD. The notion of 'tracking' some of the most common CHD risk factors in children has been used in several studies. Results from this type of research indicate that children who are at the extreme end of the distribution and have high levels of blood pressure, adverse lipid levels and are obese will continue to exhibit these coronary risk factors as they grow. The research completed at present does not answer the question of whether children who exhibit a coronary-prone risk factor profile will exhibit this same profile at an age when one is most likely to develop the clinical manifestations of CHD. It does make sense, however, to identify those children who may be at risk for developing premature CHD and to initiate safe interventions such as behaviour modification, changes in diet and increases in physical activity. These have all been shown to alter risk factors which are associated with increased relative risk of CHD in adults. It should be noted that in adults regular aerobic exercise often may alter all risk factors for CHD, including hypertension and diabetes. Whether regular aerobic exercise will induce similar changes in children is not fully understood.     

航海人员中高血压患者24小时动态血压变化特征

目的：探讨航海人员（包括水下和水面作业）中高血压患者24小时（h）动态血压监测（ABPM）的各参数变化特征。方法：选择偶测收缩压（SBP）≥140mmHg和／或舒张压（DBP）≥mmHg的37例航海人员中高血压患者24h平均SBP和DBP、白昼或夜间平均均SBP和DBP、白昼或夜间SBP和DBP负荷值、24h血压变异程度均明显高于血压正常组（P＜0．05－0．01）;高血压患者夜间SBP和DBP均值下降＞10％（＞10mmHg）;水下作业组的主血压患者白昼或夜间SBP和DBP负荷值高于水上作业组（P均＜0．01）。结论：本组航海人员中高血压患者均显示为勺型高血压,可能与轻、中度高血压（35／37）较多有关;水下作业高组血压患者负荷值升高明显,提示水下作业人员的工作环境与生活条件等受多种复杂因素影响,易产生增压反应有关。     

东海海域航海人员高血压患病率调查

目的　探讨东海海域航海人员高血压发病情况及影响因素。方法　按国标规定方法 ,测量右上肢血压 ,连续 3次 ,每次间隔 5 min以上 ,取 3次血压平均值。结果　 (1)水面船舶与水下作业人员高血压患病率相近 ,分别为 3.96 %及 3.5 5 % ,两组总患病率为 3.6 % ;(2 )上海地区海域、宁波地区海域、舟山地区海域高血压患病率之间有非常显著差异 (上海 >宁波 >舟山 ) ;(3)高血压患病率随年龄的增长而呈上升趋势 ;(4)高血压患病率与体重指数 (BMI)、遗传因素等有密切关系。结论　为减少心脑血管疾病的发生 ,预防高血压病应从早期开始并控制体重等。     

青年脑梗死危险因素和临床特点分析

目的分析青年脑梗死危险因素和临床特点。方法将我院收治的63例青年脑梗死和同时期324例老年脑梗死患者临床资料进行对比,并作统计学分析。结果青年组男性性别构成明显高于中老年组（P〈0.05）;青年组吸烟、饮酒、高血压发病率高于中老年组（均为P〈0.05）;青年组较中老年组糖尿病、肥胖、血脂异常差异无统计学意义。结论男性、高血压、吸烟、饮酒是青年脑梗死的主要危险因素,因此,对青年人开展健康宣传教育,进行早期干预,能有效减少脑梗死的发生。     

成人紫绀型法络四联症患者合并高血压的临床分析

本文总结109例四联症合并高血压患者的临床资料,重点观察临床表现并探讨临床意义。其主要临床特点是：①血压虽高,但缺乏高血压症状;②四联症患者常见的蹲踞、缺氧表现较儿童四联症患者显著减少;③尿化验有改变的发生率高（69.7%);④右心负荷较一般成人四联症明显增重。通过2例降压治疗一周诱发严重缺氧发作的教训和所有心内修复术后血压及尿改变恢复正常的经验,认识这种特殊表现的意义是：①这 种高血压是继发性高血压,成人四联症比较常见（23.7%);② 高血压具有减少右向左分流、增加肺血流的保护作用,不适当降压可诱发严重缺氧;③为防脑卒中, 造影时用硝普钠缓慢静点, 在体循环压逐渐下降而不低于右室收缩压时造影 比较安全;④心内修复术后尿改变恢复正常,表示缺氧性肾损害是可逆的。     

长期高强度噪声环境对基层部队机务人员血压的影响

目的:研究长期高强度噪声环境对军队机务人员血压的影响。方法:观察组为708名机务人员,对照组为356名男学员,比较两组血压水平及相关因素的差异;观察组按工作年限进行亚组分析。结果:①观察组平均收缩压与对照组相比无统计学差异(P>0.05),但舒张压、高血压检出率、高血压前期检出率均存在统计学差异(77.9±7.8 vs 75.8±6.9;5.1%vs1.4%;9.7%vs 4.8%;P<0.05);②观察组亚组之间平均收缩压无明显差异,舒张压、高血压及高血压前期发生率有统计学差异(P<0.05)。结论:长期高强度噪声暴露对机务人员血压有不利影响,以舒张压升高为特点。     

军队离退休干部脑卒中患者危险因素调查

目的了解军队离退休老干部脑卒中幸存者的危险因素暴露情况。方法对门诊和住院的477例脑卒中幸存者,进行危险因素调查。将研究对象以年龄分组,分析并描述脑卒中危险因素的暴露水平、血压水平及其年龄分布。结果脑卒中幸存者的原发性高血压史、心脏病、糖尿病、脑卒中家族史、原发性高血压家族史、肥胖、吸烟、饮酒的暴露率分别为62.9%、31.9%、13.0%、25.2%、31.7%、20.5%、41.9%和29.1%。各年龄组间体质指数(BM I)和舒张压水平有显著差异,随年龄增长而下降。收缩压水平≥140 mmHg者占71.9%,舒张压水平≥90 mmHg者占61%,各年龄组间舒张压水平的分布差异有统计学意义。结论军队离退休老干部脑卒中幸存者危险因素暴露处于较高水平,原发性高血压的控制率有待提高。