Cardiology Section, Temple University School of Medicine, Philadelphia, Pennsylvania.
Am J Respir Crit Care Med. 2014 Jun 15;189(12):1479-86. doi: 10.1164/rccm.201309-1662CI.
Exposure to the undersea environment has unique effects on normal physiology and can result in unique disorders that require an understanding of the effects of pressure and inert gas supersaturation on organ function and knowledge of the appropriate therapies, which can include recompression in a hyperbaric chamber. The effects of Boyle's law result in changes in volume of gas-containing spaces when exposed to the increased pressure underwater. These effects can cause middle ear and sinus injury and lung barotrauma due to lung overexpansion during ascent from depth. Disorders related to diving have unique presentations, and an understanding of the high-pressure environment is needed to properly diagnose and manage these disorders. Breathing compressed air underwater results in increased dissolved inert gas in tissues and organs. On ascent after a diving exposure, the dissolved gas can achieve a supersaturated state and can form gas bubbles in blood and tissues, with resulting tissue and organ damage. Decompression sickness can involve the musculoskeletal system, skin, inner ear, brain, and spinal cord, with characteristic signs and symptoms. Usual therapy is recompression in a hyperbaric chamber following well-established protocols. Many recreational diving candidates seek medical clearance for diving, and healthcare providers must be knowledgeable of the environmental exposure and its effects on physiologic function to properly assess individuals for fitness to dive. This review provides a basis for understanding the diving environment and its accompanying disorders and provides a basis for assessment of fitness for diving.
暴露于海底环境会对正常生理产生独特的影响，并可能导致需要了解压力和惰性气体过饱和对器官功能的影响以及适当治疗方法的独特疾病，其中包括在高压舱中进行再压缩。波义耳定律的影响导致在水下增加压力时含气空间的体积发生变化。这些影响会导致中耳和鼻窦损伤以及由于从深处上升时肺部过度膨胀而导致肺气压伤。与潜水相关的疾病具有独特的表现形式，需要了解高压环境才能正确诊断和治疗这些疾病。在水下呼吸压缩空气会导致组织和器官中增加的惰性气体溶解。潜水后上升时，溶解的气体可能达到过饱和状态，并在血液和组织中形成气泡，导致组织和器官损伤。减压病可能涉及肌肉骨骼系统、皮肤、内耳、大脑和脊髓，具有特征性的体征和症状。通常的治疗方法是按照既定方案在高压舱中再压缩。许多休闲潜水者寻求医疗许可进行潜水，医疗保健提供者必须了解环境暴露及其对生理功能的影响，以便正确评估个人潜水的适应性。本综述提供了理解潜水环境及其伴随疾病的基础，并为评估潜水适应性提供了基础。
