Decompression Sickness(DCS) Decompression Illness(DCI).ppt

Decompression Sickness(DCS) Decompression Illness(DCI) Decompression sickness is that illness which follows a reduction in environmental pressure sufficient to cause the formation of bubbles from gases dissolved in body tissues. 常压 1659年 Boyle，蛇眼内气泡 1659年 Boyle，蛇眼内气泡 1890年 Moir用加压舱治疗减压病 气泡形成的物质基础（内因） 机体内溶解的惰性气体的量足够多（达到一定的饱和程度） Diffusion Perfusion 环境因素 低温、流速、水底性质 挤压组织 生物化学作用 皮肤 痒 奇痒难忍，有灼热感或蚁走感，犹如“隔靴搔痒”，甚至将皮肤抓破也难解其痒。 运动系统 部位： 肩、肘、膝、髋 特点： 从点到面、由轻转重、性质不一、不红不肿、止痛无效、曲屈缓解 运动障碍：痉挛性或松弛性麻痹、各种类型的瘫痪 感觉障碍：过敏、麻木；痛、温、触及本体感觉迟钝或消失 神经系统（脑） 头痛，感觉和运动功能异常，浅反射消失，深反射增强；语言等高级中枢受损 临床表现 痒 疹 痛 瘫 症状出现的时间 轻型：痒、皮疹、轻度疼痛者 中型：有较严重疼痛，或有轻度的呼吸循环系统表现 重型：有明显呼吸循环系统表现，或有任何神经系统表现者 高气压暴露史 （特别是减压不当史） 减压病的症状和体征 气泡 加压鉴别 定义：是指将患者送入舱内，在适当的压力下停留一定时间，待症状消失后，再按一定方案减压出舱的全过程 压力 气泡体积 直径 气泡 加压：速度快 高压下停留 减压 压力值的确定 主要依据: 患者症状和体征对所加压力的反应； 参考: 潜水深度、发病时间的早晚、症状的轻重。 医学教育 体检 正确选择减压方案 Today, we have talked about the decompression sickness. Bubble is the cause of DCS. The bubble formation has two essential factors: one is that the body has been exposed to hyperbaric environment at certain pressure for certain period; the other is that the ambient pressure decreases fast in large amplitude. The bubbles cause disease in two ways: direct and indirect. The direct way is obstructing blood vessels and pressing tissues; the indirect way is causing a series of biochemical reaction. The manifestation of DCS may occur in many systems. The major symptoms and signs are skin itching, limb and joint pain, sensory and motor obstruction, chokes, cardiac failure and so on. In some serious cases, the patients may die from coronary artery or brain artery gas embolism. Recompression is the most specific and effective treatment to DCS. The pressure value depends on the reactions of signs and symptoms to the recompression. To prevent divers from DCS, it is very important to properly select and strictly implem