Gawthrope Ian C, Summers Matthew, Macey David J, Playford David A
Fremantle Hyperbaric Unit, Fremantle Hospital, Alma Street, PO Box 480, WA 6959, Australia, Phone: +61-(0)8-9431-2233, E-mail:
The University of Notre Dame, Fremantle, Western Australia.
Diving Hyperb Med. 2015 Mar;45(1):25-9.
Decompression sickness (DCS) results from the formation of bubbles within the tissues and blood in response to a reduction in environmental pressure. Venous gas emboli (VGE) are common after diving and are usually only present in small numbers. Greater VGE numbers are an indication of decompression stress, and can be reliably detected using ultrasound imaging.
To examine the relationship between production of VGE following a routine dive and the risk of DCS.
A matched population of divers with and without a history of DCS were monitored for the production of VGE at 15-minute intervals using ultrasound, following a 405 kPa air dive in a hyperbaric chamber using the DCIEM air decompression table. VGE production was graded using a validated grading system and the data analysed to compare maximum VGE grade and duration of VGE formation.
Eleven divers with a history of DCS were compared with 13 divers with no history of DCS. Divers with a history of DCS demonstrated both a higher maximum grade (P=0.04) and longer duration (P=0.002) of VGE production compared to divers without a history of DCS.
Higher maximum VGE grades and longer durations of VGE following decompression were associated with a history of DCS and, in particular, musculoskeletal DCS. Although the exact mechanism of DCS remains poorly understood, our data suggest some individuals are inherently more prone to develop VGE, increasing the probability of DCS. Modification of diving practices in those with high VGE grades could potentially decrease DCS risk in these individuals.
减压病（DCS）是由于环境压力降低，在组织和血液中形成气泡所致。潜水后静脉气体栓塞（VGE）很常见，通常数量较少。VGE数量较多表明存在减压应激，可通过超声成像可靠检测到。
研究常规潜水后VGE产生与DCS风险之间的关系。
在高压舱内按照DCIEM空气减压表进行405 kPa空气潜水后，使用超声以15分钟的间隔对有和没有DCS病史的配对潜水员群体进行VGE产生情况监测。使用经过验证的分级系统对VGE产生情况进行分级，并对数据进行分析，以比较最大VGE分级和VGE形成持续时间。
将11名有DCS病史的潜水员与13名无DCS病史的潜水员进行比较。与无DCS病史的潜水员相比，有DCS病史的潜水员VGE产生的最大分级更高（P = 0.04），持续时间更长（P = 0.002）。
减压后较高的最大VGE分级和较长的VGE持续时间与DCS病史相关，尤其是肌肉骨骼型DCS。尽管DCS的确切机制仍知之甚少，但我们的数据表明，一些个体天生更容易形成VGE，从而增加了患DCS的可能性。对VGE分级高的个体的潜水习惯进行调整可能会降低这些个体患DCS的风险。
