模拟航海刺激对人生命体征的影响

目的探讨航海刺激对人生命体征的影响,为研究海战伤救治快通道麻醉方案提供依据。方法采用旋椅试验制备运动病临床模型。根据旋椅运行模式不同,将200名受试者随机均分为Ⅰ～Ⅴ组（n=40/组）,观察晕船发生率及其临床表现,连续监测收缩压（systolic blood pressure,SBP）、舒张压（diastolic blood pressure,DBP）、平均压（meanarterial pressure,MAP）、心率（heart rate,HR）、脉搏氧饱和度（pulse oxygen saturation,SpO2）、呼气末二氧化碳分压（end-tidal carbon dioxide pressure,PETCO2）以及Ramsay镇静评分、熵指数的动态变化。结果在5种运行模式中,Ⅴ组（先双向运行5 min→再单向逆时针加减速运行5 min）不仅晕船率最高（90%）,而且所需旋转时间最短（8.35±1.72）min]。94.4%晕船者有头晕,持续近30（29.86±7.59）min,50%以上有心悸（慌）、恶心和表情淡漠等表现,12%有短暂（8.27±4.51）min]嗜睡。旋转刺激后HR以减慢为主,15 min内均明显低于基础值（P〈0.01）,有3例心率低于50/min;约1/3受试者血压下降。在旋转后5 min内,Ramsay镇静评分为2.04±0.05,状态熵（state entropy,SE）和反应熵（response entropy,RE）值均明显降低（P〈0.01）,最低值分别降至66%和52%。结论模拟航海刺激可引起植物神经功能紊乱,主要表现为副交感功能亢进,可引起＂舰员＂明显不适、工作效率下降,机体储备代偿能力降低。

Effect of Simulated Navigation Stimulation on the Vital Signs of Human

Objective To explore the effect of simulated navigation stimulation on the vital signs of humans,and supply reference for further study on the schema of fast-tacking anesthesia in sea-war wound treatment.Methods Rotation-chair test was used to make clinical model of motion sickness.A total of 200 subjects were randomly divided into groups Ⅰ-Ⅴ according to different rotation models(n=40/group).The incidence rate and clinical signs of seasickness were observed.The dynamic changes of systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),end-tidal carbon dioxide pressure(PETCO2),Ramsay’s sedative score and entropy index were measured.Results Among the 5 groups,the seasickness rate was the highest(90%) and the required rotation time was the shortest (8.35±1.72) min] in group Ⅴ(two-way rotation for 5 minutes first and then one-way and anti-clockwise speedup and speeddown rotation for 5 minutes).Dizziness rate in the seasickness persons was about 94.4%,and the duration time was about 30(29.86±7.59) minutes.More than 50% seasickness persons had palpitation,nausea and apathia,12% had temporary hypersomnia and the duration time was(8.27±4.51) minutes.After the rotation,HR slowdown was the major characteristic.The HR was significantly lower than the basicline within 15 minutes(P<0.01),and lower than 50 beats/min in 3 cases.Blood pressure was reduced in 1/3 subjects.Within 5 minutes,the Ramsay′s sedative score was(2.04±0.05).State entropy(SE) and response entropy(RE) were significantly reduced(P<0.01),and the lowest SE and RE were 66% and 52% respectively.Conclusion Simulated navigation stimulation can cause autonomic nerve disorder which exhibits mainly the parasympathatic nerve hyperfunction,obvious unwellness,decreasedwork efficiency and reduced physical reserve and compensation of the "navigators".