摘要
目的分析对首次再加压治疗效果欠佳减压病患者实施较高压力(≥70m)方案治疗的疗效。方法选择2011年9月至2018年6月中国人民解放军东部战区海军医院收治的40例Ⅱ型减压病患者,按入院前是否已在外院接受了再加压治疗分为二次加压组(6人)和本院首诊组(34人)。二次加压组为发病后首次再加压治疗(低压力吸氧方案)效果欠佳后转至我院患者,采用《海军医学研究所空气潜水减压病加压治疗表》方案Ⅴ(氧)》,治疗方案70m(绝对压0.70MPa),吸氧总时间225min。本院首诊组为同期收治的Ⅱ型减压病患者。统计分析2组较高治疗压力方案延迟时间、使用率、疗效。结果二次加压组的再加压治疗前延迟时间[(14.5±4.9)h]明显长于本院首诊组[(4.3±3.0)h],差异有统计学意义(P<0.001)。二次加压组的较高治疗压力方案使用率(83.3%)高于本院首诊组(5.9%),差异有统计学意义(P<0.001)。2组的疗效类似,差异无统计学意义(P=0.585)。结论较高治疗压力方案可以有效治疗首次再加压治疗效果欠佳的减压病患者。对于延迟治疗的减压病患者,合适的再加压治疗方案也可获得满意的有效率。在低压力吸氧方案、辅助治疗手段等疗效有限的情况下,对Ⅱ型减压病患者要尽快安排较高治疗压力的再加压治疗。
Objective To analyze the efficacy of higher pressure recompression therapy(≥70 m)in the patients with decompression sickness(DCS),who displayed poor efficacy after initial recompression.MethodsForty patients with typeⅡDCS who received treatment in our hospital from September 2011 to June 2018 were selected as research subjects,and were designated as the study group(n=6)and the control group(n=34),in accordance with whether or not they had received recompression therapy before admission into hospital.The DCS patients of the study group were those transferred to our hospital after initial lower pressure recompression treatment with unsatisfactory results.These patients were treated with the Air Diving DCS Recompression Treatment Table(Table 5,Oxygen Breathing)developed by the Chinese Naval Medical Research Institute,at a pressure of 70 meters and with a total oxygen breathing time of 225 minutes.The patients of the control group were those with type II DCS patients who received initial recompression treatment in our hospital within the same time span.Delayed time,application rate and treatment efficacy in the patients of the 2 groups were analyzed statistically.ResultsThe delayed time(14.5±4.9 h)of the secondary recompression group(or the study group)was obviously longer than that of the control group(4.3±3.0 h)(P<0.001),and there was statistical significance when comparisons were made between them(P<0.001).The application rate of higher pressure treatment profile in the secondary recompression group(83.3%)was higher than that of the control group(5.9%),also with statistical significance(P<0.001).The treatment efficacy of the 2 group was identical,without statistical significance(P=0.585).ConclusionThe higher pressure recompression profile could effectively treat those DCS patients who showed unsatisfactory treatment effects after initial recompression.For those DCS patients with delayed treatment,proper recompression profile could also achieve satisfactory treatment outcome.With the lack of low pressure oxygen-breathing treatment profile and other supplementary treatment methods,secondary higher pressure recompression treatment should be performed as early possible,in the treatment of the patients with type II DCS.
作者
沈泉
王巍巍
方以群
孙瑞佼
包晓辰
唐永梅
帅力
欧崇阳
吴建国
Shen Quan;Wang Weiwei;Fang Yiqun;Sun Ruijiao;Bao Xiaochen;Tang Yongmei;Shuai Li;Ou Chongyang;Wu Jianguo(Department of Hyperharic Medicine,Nary Hospital,East Combat Zone of CPl.4,Zhoushan 316000,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2019年第1期15-18,共4页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
基金
军队后勤科研计划面上项目(CHJ16L041).
关键词
减压病
较高治疗压力
再加压治疗
Decompression sickness
Higher pressure therapy
Recompression therapy
