模拟100m氦氧饱和-120m巡回潜水中四名潜水员的动态心电图变化

模拟１００ｍ氦氧饱和－１２０ｍ巡回潜水中四名潜水员的动态心电图变化唐亦奇唐儒清为了解模拟１００ｍ氦氧饱和－１２０ｍ巡回潜水过程对潜水员心电活动的影响，作者对实验中４名潜水员进行了２４小时动态心电图（ＤＣＧ）检查，现将结果分析报道如下。一、对象与方法４...     

模拟480m氦氧饱和-493m巡回潜水实验研究的设备保障

目的 保障模拟480 m氦氧饱和-493 m巡回潜水实验的顺利进行,检验饱和潜水设备保障方案.方法 4名潜水员利用500 m饱和潜水系统和KMB18(B)潜水装具,在实验室进行模拟大深度饱和-巡回潜水.实验前通过维修、调试设备,使其处于备便状态.实验中按照设备保障方案,控制舱内环境压力、氧(O2)分压、二氧化碳( CO2)分压及温湿度参数,保障潜水员完成水下巡潜作业及日常饮食起居,确保潜水员按时、顺利、安全出舱.结果 经过82 h加压后,达到的饱和深度为480 m,4名潜水员在此深度下停留49.6h,达到巡潜最大深度493m;减压时间约302.4 h,高压暴露总时间为434 h.加压过程和饱和逗留期间维持O2分压35 ～45 kPa,减压时维持O2分压48～52 kPa,减压至12 m后,维持O2浓度21％ ～23％;CO2分压一般限制在0.5 kPa以内.相对湿度60％～80％;居住舱内温度29～32℃.结论 潜水员出舱后身体状况良好,感觉舱内环境控制比较舒适,设备保障结果与预想方案吻合,设备保障方案成功.     

350m模拟氦氧饱和潜水中人体环核苷酸的变化

３５０ｍ模拟氦氧饱和潜水中人体环核苷酸的变化于志洁，朱磊有关３５０ｍ模拟氦氧饱和潜水中人体生理功能的变化已经报道［１］。本文补充报告在同一实验中观测的人体血中环核苷酸含量的变化情况，供作参考。一、材料和方法（一）潜水员选择及实验条件：有４名潜水员（编...     

海上氦氧150m饱和-182m巡回潜水训练医学保障

目的：通过采取有针对性的医学保障措施，安全地实现潜水深度新的提升，提高我军潜水能力。方法：8名海军潜水员利用国产船载甲板居住舱－潜水钟饱和潜水设备系统进行氦氧饱和－巡回潜水。潜水员经139min加压至相当于150m水深的饱和压力，最大巡潜深度182m 9人次，巡潜时间累计2h 35min，饱和暴露34h后，经过163h的饱和减压回到常压，饱和潜水全程199h。采用高压下专用心电、脑电监护仪对舱内的潜水员进行同时监护，减压过程中进行多普勒超声气泡音监测。巡回潜水后外用抑菌药物预防外耳道炎。在潜水过程的不同阶段分别进行了呼吸、免疫、应激功能等指标的检测。结果：8名潜水员完成高压暴露199h后，有轻度虚弱感，2周内消失；无减压病症状发生，多普勒超声气泡检测未听到气泡音。在饱和暴露时，4名潜水员出现窦性心率不齐，1名T波低平，50h后恢复。免疫功能指标IL－6、IL－8在饱和潜水结束后显著升高（P＜0．001）；应激功能指标AVP、CRH、ACTH、Dyn A含量在潜水后均明显升高（P＜0．05或＜0．01）。在150m饱和阶段，肺通气功能指标FEF25％、FEF50％、FEF75％降低的幅度分别为25．51％，42．35％，56．84％，减压结束24h后均恢复正常。结论：生理指标监测结果说明本次潜水过程中，潜水员机体处于应激状态。通过切实可行的医学保障措施和医学监护手段，对此次现场实际潜水训练提供了有力的保障。     

坚持海洋现场教学,培养合格潜水医师

为提高潜水作业部门潜水现场的医学保障能力，我们将课堂教学同潜水现场教学有机结合，利用国内难得的１０次大深度潜水和１次三级援潜训练的机会，组织了海军有关防险救生大队和部分潜艇医务人员进行了１０次现场潜水培训，其中 １９８７年 ８０ ｍ氦氧饱和－１００ ｍ巡潜、１９９１年 １００ ｍ氦氧饱和－１１２ ｍ巡潜、２０００年 １１９ ｍ氦氧Ｂｏｕｎｃｅ潜水均超过或接近当时我国海上现场潜水最大深度；三级援潜海上现场教学也是我国仅有的１次尝试。 一、现场教学的组织和内容 １．准备工作：主要内容包括明确目的：是一种理论与…     

氦氧140 m饱和-166 m巡回潜水医学保障的研究

目的为提高海军部队的防险救生能力,培养一批适应大深度饱和潜水的潜水员和从事相应深度的潜水医学保障及设备保障人员.方法 8名海军潜水员,在氧分压值为(40±2)kPa与140 m氦氧混合气环境的居住舱内饱和48 h,并在此期间6次巡回潜水到164～166 m海底,有效完成了预定的水下作业任务,最后,经149h 20min减压,安全返回常压.根据现场条件,在全面临床体检和常规指标检查的基础上,在潜水过程的不同阶段分别进行了神经、心理、呼吸、心血管、免疫、应激、运动及平衡、听觉等各系统功能的医学、生理学及生物化学等指标的检测.结果在饱和-巡潜阶段,潜水员普遍存在焦虑、恐怖或抑郁表现;肺功能最大通气量(MVV)随深度增加呈显著降低;滚珠投递准确率明显降低;ACTH、皮质醇等应激激素水平显著提高.结论本次医学保障措施切实有效,使潜水达到了预期目的,机体所出现的变化均为暂时的和可逆的.     

海上120 m氦氧饱和-150 m巡回潜水人体心电图变化

在海军一次海上人体１２０ｍ氦氧饱和－１５０ｍ巡回潜水实验过程中,作者等对８名参试潜水员进行了心电图变化监测,报告如下。一、对象与方法本次实验受试者与实施方法见本期２１４～２１５页。心电图检测选用意大利“ＭＩＣＲＯＲＵＬＥＲ１２／１”微型心电图机,分别在加压前、饱和暴露、减压过程中及出舱后各时期对８名潜水员进行检查。二、结果１．心率：高压下各时期８名潜水员的心率均有所下降。其平均值与加压前（对照值）比较,１２０ｍ饱和暴露时期（ＰＯ２＝４０ｋＰａ）下降１２．８％;１２０ｍ饱和减压前２小时（ＰＯ２＝５…     

法国潜水员创氢氦氧潜水世界纪录──701m

法国潜水员创氢氦氧潜水世界纪录──７０１ｍ１９９２年１１月２０日１０：５７，法国Ｃｏｒｎｅｘ公司的１名潜水员在模拟潜水设备中到达７０１ｍ深度，创造了氢氦氧潜水的世界纪录。本次实验是法国Ｈｙｄｒａ系列实验的第１０次，在前９次实验中，最大实验深度５０１ｍ...     

模拟1100kPa氦氧饱和潜水时人脑干听觉诱发电位潜伏时的变化

模拟１１００ｋＰａ氦氧饱和潜水时人脑干听觉诱发电位潜伏时的变化肖卫兵张庆陵潘令松唐儒清在高分压氦环境下，人以及大多数的脊椎动物会出一现系列神经系统的症状，称作高压神经综合征（ＨＰＮＳ）。对脑电的变化以及手指震颤等指标的观察可以监视ＨＰＮＳ的大致规律，...     

中美联合25m氮氧饱和─80m氦氮氧巡回潜水实验的医学保障

中美联合２５ｍ氮氧饱和－８０ｍ氦氮氧巡回潜水实验的医学保障袁洪昌，荆岩林，周述尧，曲青林关键词潜水，氮氧饱和，巡回潜水，氦氮氧，减压，医学保障ＴｈｅｍｅｄｉｃａｌｓｕｐｐｏｒｔｏｆｔｈｅＣｈｉｎａ－ＵＳＡｊｏｉｎｔＣｈｉｓａｔ－Ⅱｓｉｍｕｌａｔｅｄ２...     

Changes in blood constituents in rats administered morphine and subjected to He-O2 at 11 ATA.

Changes in blood constituents in rats exposed to He-O2 at 1 ATA and 11 ATA after administration of morphine (100 mg/kg) are reported. Injected animals are compared with controls (non-injected) in ambient air and animals subjected to He-O2 at 1 ATA and 11 ATA. Temperature of the chamber was controlled and O2 partial pressure and CO2 levels were maintained at standard conditions. After morphine injection the rats were pressurized and maintained for 4 h before decompression, at which time additional blood samples were obtained. Morphine-injected animals in ambient air showed significant decreases in hematocrit, MCV, glucose, and protein in the blood while showing an increase in the leukocyte count and blood potassium. Non-injected animals maintained in He-O2 at 1 ATA and 11 ATA showed no deviation from ambient air control animals. Injected animals in He-O2 at 1 ATA showed no changes from those in ambient air, but animals injected and exposed to 11 ATA did not have a decreased serum protein level or an increase in potassium.     

Arterial blood gases during diving in elite apnea divers

Elite apnea divers have considerably extended the limits of dive depth and duration but the mechanisms allowing humans to tolerate the compression- and decompression-induced changes in alveolar gas partial pressures are still not fully understood. Therefore we measured arterial blood gas tensions and acid-base-status in two elite apnea divers during simulated wet dives lasting 3 : 55 and 5 : 05 minutes, respectively. Arterial pO2 followed the compression-(from 13.8/16.9 kPa before the dive to 30 kPa at the start of the bottom time) and decompression-induced (from 13.7/21.0 kPa to 3.3/4.9 kPa immediately after surfacing) variations of ambient pressure, while the arterial pCO2 remained within the physiologic range (3.0/3.9 kPa before diving vs. 5.7/5.9 kPa at the end of the bottom time), probably due to the CO2 storage capacity of the blood. These findings may help to explain why humans can sustain deep and long apnea dives without major increases in respiratory drive.     

Pulmonary function of recreational divers: a cross sectional study

Long term effects on respiratory function have been found in adult professional divers and have indicated the development of small-airway disease. The aim of this report was to investigate pulmonary lung function and breathing pattern of recreational divers, especially in young subjects. Pulmonary function was measured in 84 air divers (aged 8 - 38 years) and in a matched control group of 89 subjects (aged 8 - 34 years). Static lung volumes, dynamic lung volumes and flows, transfer factor for carbon monoxide (T(Lco) ), maximal static pressures and CO(2) rebreathing test were measured. We observed no significant differences for all lung function parameters between divers and non divers in children and adolescents. Adult air divers showed a significant decrease in T(Lco) in absolute values (5.74 vs 6.26 ml x min(-1) x mmHg(-1) x l(-1), p = 0.03) and normal values and no significant difference in % predicted (112 vs 119 %), a higher maximal inspiratory pressure at functional residual capacity (-92 vs -74 cm H(2)O, p < 0.05) and at residual volume (-108 vs -88 cm H(2)O, p < 0.05) than adult controls. Adult divers also had a decreased resting respiratory frequency (13 c x min (-1) vs 17 c x min (-1) respectively, p < 0.01) and a higher carbon dioxide threshold (52 mm Hg vs 49 mm Hg respectively, p < 0.05) than adult controls. No significant differences occurred between adults divers and non divers for obstruction parameters. In this study, no airway obstruction or transfer factor reduction was observed in young recreational divers. Lower CO(2) threshold and higher inspiratory pressure were obtained in adult recreational divers compared to controls.     

人体在不通风密闭服中的生理调节

目的 研究实验用密闭服在不通风条件下对人体生理机能的影响及其防窒息的作用。方法 ５名年龄为１８～２１岁的健康男性分别在密闭服调节阀开关被置于Ａ和Ｂ两种不同位置的密闭服中进行测试。结果 ⑴在清醒静卧,外界大气压为１ａｔｍ的条件下,被试者在面窗关闭且调节阀与外界相通的密闭服中,耐受时间至少可达１５ｍｉｎ;⑵被试者口前区Ｏ２和ＣＯ２分压在头盔面窗关闭５～７ｍｉｎ后者可出现一个平衡状态,并持续到实验结束;     

海上150 m氦氧饱和-182 m巡回潜水时潜水员血清IL-1、IL-2R和TNF-α的改变

目的研究海上大深度饱和潜水时潜水员IL-1、IL-2R和TNF-α含量的变化.方法分别于饱和潜水前后以ELISA法检测8名潜水员在饱和前后血清中IL-1、IL-2R和TNF-α的含量.结果 8名饱和潜水员血清TNF-α含量均小于0.01 ng/L,饱和潜水前后无显著性变化,饱和潜水后血清中IL-1、IL-2R的含量较饱和潜水前有非常显著地增加(P<0.01).结论大深度饱和潜水对潜水员血清IL-1、IL-2R含量有明显作用.     

350m模拟氦氧饱和潜水中人体生理功能变化的研究

本研究的目的在于了解人体在大深度高气压条件下长期生活工作时的生理功能变化规律、作业和适应能力。在３５０ｍ模拟氦氧饱和潜水的不同阶段监测了潜水员的中枢神经－心理运动、肺通气、心血管、免疫、消化等功能的一系列医学－生理学指标，获得的资料为今后海上大深度饱和潜水实际应用提供了科学依据。     

Training improves divers' ability to detect increased CO2

BACKGROUND: Elevated arterial PCO2 (hypercapnia) is a known risk in diving with closed circuit breathing apparatus. In a retrospective study, we determined CO2 retention and the ability to detect CO2 in novice divers who were either CO2-recognition-trained subjects (TS) or untrained subjects (UTS). METHODS: Ventilatory and perceptual responses to variations in inspired CO2 (range 0-5.6 kPa, 0-42 mm Hg) during moderate exercise were assessed in novice Israeli Navy divers on active duty. Tests were carried out on 231 TS and 213 UTS. RESULTS: The minimal mean inspired PCO2 that could be detected was 4.8 +/- 1.6 kPa (36 +/- 12 mm Hg) in UTS and 2.9 +/- 0.7 kPa (22 +/- 5 mm Hg) in TS (p < 0.0001). No significant changes were found in PETCO2 between the two groups during exposure to a PICO2 of 5.6 kPa (42 mm Hg). There were 46 TS who were found to be CO2 retainers (more than +1 SD above the mean) and 19 were classified as poor detectors (more than +1 SD above the mean). Seven subjects exhibited both traits. During actual oxygen diving performed later by this group, the only four cases of CNS-oxygen toxicity were among those seven subjects (p < 0.01). CONCLUSIONS: We conclude that CO2 recognition training improves the diver's capability to detect CO2. We suggest that a diver who is both a poor CO2 detector and a CO2 retainer will be prone to CNS-oxygen toxicity.     

氦氧140 m饱和-166 m巡回潜水对潜水员肺呼吸功能的影响

目的：研究海上饱和潜水对潜水员肺呼吸功能的影响。方法：在海上氦氧140m饱和－166m巡回潜水实验中，检测8名潜水员在各个不同深度条件下的肺功能，分析肺功能与呼吸气体密度的关系。结果：呼吸气体密度和导热系数的变化对肺静态容积指标值未产生明显影响，在所有潜水阶段均保持在正常参考值范围；肺动态容积指标最大通气量（MVV）随度增加而显著降低（P＜0．01），饱和深度（140m)时降低41％（P＜0．01），MVV与呼吸气体密度的平方成反比；在不同深度下，呼吸频率保持相对稳定，其他动态肺容积指标与MVV变化趋向一致；V75，V50，V25三者斜率下降，其中V75最大，V50次之，V25最小。减压过程中，所有这些改变均随着暴露压力的降低逐渐恢复正常。结论：饱和潜水过程中，潜水员静态肺功能无明显变化。高压氦氧混合气对潜水员肺呼吸功能存在一定影响，应引起重视。但所有这些改变均属可逆性改变。