摘要
目的通过分析因娱乐潜水出现不适症状患者的临床资料,总结其临床特征、第一诊断及就诊情况,为潜水医师对娱乐潜水不适症状患者的诊断和鉴别诊断提供借鉴。方法回顾性分析解放军总医院第六医学中心高压氧科2011年10月至2018年10月收治的因娱乐潜水导致不适的门诊及住院患者临床资料102例。分析患者年龄、性别等一般性资料,以及潜水史、第一诊断、患者首诊科室、确诊科室、辗转科室数等就诊相关资料。结果纳入研究的102例患者中,年龄30~44岁占比最高(49.0%);不适症状中以头晕、头痛最常见(34.3%);临床症状主要累及器官为头部、心肺及消化道。女性消化道及植物神经系统症状多于男性,差异有统计学意义(P<0.05)。娱乐潜水下潜深度<10 m者占84.3%;反复潜水者占42.2%;患者临床不适症状发生在出水之后为69.6%;减压病在患者诊断中的构成比仅占16.7%。患者首诊科室以急诊科最多(51.9%),首诊至确诊之间平均辗转科室(2.2±1.7)个。反复潜水、下潜深度、可疑不当减压史、症状出现时间与减压病的诊断有明显相关性,差异均有统计学意义(P<0.05);年龄、性别、既往参加运动频次、潜水时紧张或恐慌与非减压病诊断有明显相关性,差异有统计学意义(P<0.05)。结论对于娱乐潜水出现不适症状的患者,其诊断需要考虑减压病之外的其他疾病。
Objective To provide a reference for diving medical doctors on the diagnosis and differentiation of the patients with discomfort symptoms after recreational diving,by analyzing those patients′clinical data and summarizing the features of clinical symptoms,the first diagnosis and consultation at the clinical visit.Methods The clinical data of 102 outpatients and inpatients with discomfort after recreational diving admitted in and visited the Department of Hyperbaric Oxygen of the Sixth Medical Center of PLA General Hospital from October 2011 to October 2018 were retrospectively analyzed.The age,gender and other demographical data of the patients,as well as the diving history,the first diagnosis,the first consulted department,the department that made confirmed diagnosis,and the number of departments that the patients were transferred,were analyzed.Results Among the 102 patients included in the study,the age of 30-44 years old accounted for the highest proportion(49.0%),dizziness and headache were the most common symptoms(34.3%)among all discomfort symptoms,and the clinical symptoms mainly involved head,heart,lung,and digestive system.The symptoms of digestive system and the vegetative nervous system were more commonly seen in women than those in men.The diving depths which was less than 10 meters accounted for 84.3%.The majority of patients experienced multiple dives within 24 hours(42.2%).The patients who had the discomfort symptoms after arriving at surface accounted for 69.6%.The proportion of decompression sickness in the diagnosis only accounted for 16.7%.The emergency department was the most-visited department(51.9%)within all the first consulted departments.The average number of departments in which the patients were transferred between the first consulted department and the department that made confirmed diagnosis was 2.2±1.7.Multiple dives,diving depth,suspected history of improper decompression,and the time of symptoms appearing were all significantly correlated with the diagnosis of decompression sickness(P<0.05).Age,sex,the frequency of previous exercise,stress or panic during the diving were significantly correlated with the diagnosis of non-decompression sickness(P<0.05).Conclusion Regarding the diagnosis of the patients with discomfort symptoms after recreational diving,diagnosis other than decompression sickness should be considered.
作者
李航
王海东
张晓菁
潘树义
Li Hang;Wang Haidong;Zhang Xiaojing;Pan Shuyi(Department of Hyperbaric Oxygen,The Sixth Medical Center of PLA General Hospital,Beijing 100048,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2020年第3期300-304,308,共6页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
基金
北京市科技新星计划(Z171100001117092)
国家自然科学基金(81500669)
广州省医学科学技术研究基金(A2016556)
海军总医院创新培育基金(CXPY201816)。
关键词
娱乐潜水
临床特征
诊断
Recreational diving
Clinical features
Diagosis
