临床实践中的潜水医学。
Diving medicine in clinical practice.
作者信息
Eichhorn Lars, Leyk Dieter
机构信息
Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Central Institute of the German Armed Forces' Medical Service, Department IV-Military Ergonomics and Exercise Physiology-Koblenz, Research Group Epidemiology of Performance, Institute for Physiology and Anatomy, German Sport University Cologne.
出版信息
Dtsch Arztebl Int. 2015 Feb 27;112(9):147-57; quiz 158. doi: 10.3238/arztebl.2015.0147.
BACKGROUND
Diving is a popular sport, and some recreational divers have medical risk factors. Their health can be endangered by high extracorporeal (ambient) pressure and its many systemic effects.
METHODS
We review relevant publications on free (breath-hold) diving, scuba diving, medical evaluation for diving, barotrauma, decompression sickness, and diving with medical risk factors, which were retrieved by a selective search of PubMed.
RESULTS
Free diving or scuba diving, even at seemingly innocuous depths, puts considerable stress on the cardio - vascular system, ears, and lungs. Unexpected events while diving, diminished functional reserve, and pre-existing medical illnesses increase the risk of a diving accident. An international survey revealed that minor incidents occur in 1.3% of all dives, and decompression accidents in 2 of every 10 000 dives. A properly conducted medical examination to determine diving fitness, followed by appropriate counseling, can make a life-threatening diving accident less likely.
CONCLUSION
To be able to certify diving fitness and give competent medical advice about diving, physicians must be well informed about the physical and physiological changes of diving and the associated risks to health, and they need to know how to perform a medical evaluation of prospective divers. In Germany, any licensed physician may judge a person fit to dive. It is recommended that this be done in adherence to the relevant evaluation standards and recommendations of the medical specialty associations. Randomized controlled trials on the effect of preventive behavior would be desirable, as would a central registry of diving accidents.
背景
潜水是一项广受欢迎的运动，一些休闲潜水者存在医学风险因素。高体外（环境）压力及其诸多全身影响可能危及他们的健康。
方法
我们回顾了关于自由（屏气）潜水、水肺潜水、潜水医学评估、气压伤、减压病以及有医学风险因素者潜水的相关出版物，这些是通过对PubMed进行选择性检索获取的。
结果
自由潜水或水肺潜水，即使在看似无害的深度，也会给心血管系统、耳朵和肺部带来相当大的压力。潜水时的意外事件、功能储备下降以及既往存在的疾病会增加潜水事故的风险。一项国际调查显示，所有潜水中1.3%会发生小事故，每10000次潜水中有2次会发生减压事故。进行适当的医学检查以确定潜水适宜性，随后给予适当的咨询，可降低危及生命的潜水事故发生的可能性。
结论
为了能够认证潜水适宜性并提供有关潜水的专业医学建议，医生必须充分了解潜水的物理和生理变化以及相关健康风险，并且需要知道如何对潜在潜水者进行医学评估。在德国，任何有执照的医生都可以判断一个人是否适合潜水。建议按照医学专业协会的相关评估标准和建议进行此项工作。关于预防行为效果的随机对照试验以及潜水事故中央登记处都将是可取的。
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