反复潜水后急性减压病的临床分析

发布时间：2018-06-13 20:54

本文选题：潜水 + 减压病　；参考：《中华劳动卫生职业病杂志》2007年08期

【摘要】：目的分析反复潜水后急性减压病患者的临床特点,探讨在常规按个体化治疗方案不能实施的情况下同时治疗多个患者的方案选择。方法统计影响疗效和复发率的因素及临床症状,依照症状和体征对所加压力的反应情况选择治疗方案,根据不同治疗方案分A组、B组、C组、D组。结果本组治愈90例(78.26%),好转25例(21.74%),无效0例,复发19例(16.52%)。(1)年龄、工龄、潜水深度、水下工作时间及初发或再发与疗效呈正相关(P0.05或P0.01),并且年龄、工龄、劳动强度、潜水深度、初发或再发、疼痛程度与复发否也呈正相关(P0.05或P0.01);而潜伏期与疗效及复发否呈负相关(P0.01);(2)年龄、潜水深度、初发或再发与疼痛程度呈正相关(P0.05,P0.01);潜伏期与疼痛程度呈负相关(P0.05);(3)治疗方案、工龄、潜水深度和潜伏期4个因素可解释疗效变化的48.0%;(4)不同治疗压力中D组、C组、B组治愈率较A组明显提高,而复发率明显低于A组,差异均有统计学意义(P0.01,P0.05);(5)相同治疗压力不同治疗时间中D组治愈率明显高于B组,复发率明显低于B组;(6)相同治疗压力相同治疗时间中D组治愈率较C组治愈率明显提高。结论在氧舱条件受限的情况下,其治疗应首选D组的吸氧Ⅳ方案,不必过分拘泥于每个个体症状和体征对压力的反应情况同时进舱。并且根据患者的临床症状适当延长高压下停留时间,一般不超过120min。
[Abstract]:Objective to analyze the clinical characteristics of patients with acute decompression disease after repeated diving, and to explore the options of treating multiple patients simultaneously under the condition that the routine individualized treatment can not be carried out. Methods the factors and clinical symptoms affecting the curative effect and recurrence rate were statistically analyzed. According to the response of symptoms and signs to the pressure added, the treatment scheme was selected and divided into two groups: group A and group B and group C were divided into group D and group C according to different treatment schemes. Results 90 cases were cured, 25 cases were improved, 0 cases were ineffective, 19 cases were relapsed, such as age, working age, diving depth, underwater working time and initial or recurrent time, which were positively correlated with curative effect (P0.05 or P0.01), and age, length of service, intensity of labor, depth of diving, depth of diving were positively correlated with the curative effect (P 0.05 or P 0.01), and age, length of service, intensity of labor, depth of diving, depth of diving were positively correlated with the curative effect. There was a positive correlation between the degree of pain and recurrence (P 0.05 or P 0.01), and a negative correlation between latency and curative effect and recurrence (P 0.01 / 2) age and depth of diving. There was a positive correlation between the initial or recurrent pain and the degree of pain (P 0.05) and a negative correlation between the latent period and the degree of pain (P 0.05). The four factors of diving depth and latent period could explain the change of curative effect 48.0%) the cure rate of group D was significantly higher than that of group A, but the recurrence rate was significantly lower than that of group A. The cure rate of group D was significantly higher than that of group B, and the recurrence rate of group D was significantly lower than that of group B (P 0.01). The cure rate of group D was significantly higher than that of group C in the same time of treatment under the same treatment pressure. Conclusion under the condition of limited oxygen chamber condition, the treatment of oxygen intake IV in group D should be the first choice, and it should not be excessively restricted to the response of each individual symptom and sign to pressure. And according to the patient's clinical symptoms appropriate extension of the duration of stay under high pressure, generally not more than 120 minutes.
【作者单位】：福建省立医院高压氧室;南京军区福州总医院高压氧科;
【分类号】：R84

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