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潜水员的肺水肿:病理生理学与计算风险分析

Pulmonary oedema in SCUBA divers: pathophysiology and computed risk analysis.

作者信息

Halpern Pinchas, Gefen Amit, Sorkine Patrick, Elad David

机构信息

Department of Emergency Medicine Sackler Faculty of Medicine, Tel Aviv University, Israel.

出版信息

Eur J Emerg Med. 2003 Mar;10(1):35-41. doi: 10.1097/00063110-200303000-00010.

Abstract

SCUBA diving has become a popular sport, with an increasing number of people participating in it. Although it is an essentially very safe activity, several specific medical problems are associated with diving. The present paper addresses diving-related pulmonary oedema, which is a rarely reported condition. It has been described mostly in cold water diving, and its occurrence in warm water has not been documented before. We delineate the pathophysiology of this condition and its treatment, and use a novel computational model to analyse further the mechanisms leading to diving-related pulmonary oedema. A better understanding of diving-related pulmonary oedema may lead to earlier recognition and treatment, and, potentially, to its prevention. The physiological mechanisms likely to lead to diving-related pulmonary oedema are well recognized. Consequently, we could design and construct a bio-mechanical computer model of the alveolar septa to explore the pathophysiology of diving-related pulmonary oedema and the vulnerability of individual divers as they relate to some mechanical characteristics of their lung structure. The physiological mechanisms of diving-related pulmonary oedema and the results provided by the computational model successfully delineated the process. The model predicted that the risk of injury is significantly increased in individuals who have a stiffer lung parenchyma or lower lung compliance values.

摘要

水肺潜水已成为一项受欢迎的运动,参与人数不断增加。尽管它本质上是一项非常安全的活动,但潜水会引发一些特定的医学问题。本文探讨与潜水相关的肺水肿,这是一种鲜有报道的病症。它大多在冷水潜水中被描述过,此前尚未有在温水中发生的记录。我们阐述了这种病症的病理生理学及其治疗方法,并使用一种新颖的计算模型进一步分析导致与潜水相关肺水肿的机制。对与潜水相关肺水肿的更好理解可能会带来更早的识别和治疗,甚至有可能实现预防。导致与潜水相关肺水肿的生理机制已得到充分认识。因此,我们能够设计并构建一个肺泡隔的生物力学计算机模型,以探究与潜水相关肺水肿的病理生理学以及个体潜水员与他们肺部结构的某些力学特性相关的易感性。与潜水相关肺水肿的生理机制以及计算模型提供的结果成功地描绘了这一过程。该模型预测,肺实质较硬或肺顺应性值较低的个体受伤风险会显著增加。

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