Tetzlaff Kay, Thomas Paul S
Dept of Sports Medicine, Medical Clinic, Eberhard-Karls-University of Tübingen, Tübingen, Germany
Faculty of Medicine, University of New South Wales, Sydney, Australia.
Eur Respir Rev. 2017 Mar 29;26(143). doi: 10.1183/16000617.0097-2016. Print 2017 Mar 31.
The diving environment provides a challenge to the lung, including exposure to high ambient pressure, altered gas characteristics and cardiovascular effects on the pulmonary circulation. Several factors associated with diving affect pulmonary function acutely and can potentially cause prolonged effects that may accumulate gradually with repeated diving exposure. Evidence from experimental deep dives and longitudinal studies suggests long-term adverse effects of diving on the lungs in commercial deep divers, such as the development of small airways disease and accelerated loss of lung function. In addition, there is an accumulating body of evidence that diving with self-contained underwater breathing apparatus (scuba) may not be associated with deleterious effects on pulmonary function. Although changes in pulmonary function after single scuba dives have been found to be associated with immersion, ambient cold temperatures and decompression stress, changes in lung function were small and suggest a low likelihood of clinical significance. Recent evidence points to no accelerated loss of lung function in military or recreational scuba divers over time. Thus, the impact of diving on pulmonary function largely depends on factors associated with the individual diving exposure. However, in susceptible subjects clinically relevant worsening of lung function may occur even after single shallow-water scuba dives.
潜水环境对肺部构成挑战，包括暴露于高环境压力、气体特性改变以及心血管对肺循环的影响。与潜水相关的几个因素会急性影响肺功能，并可能导致长期影响，这些影响可能随着反复潜水暴露而逐渐累积。来自实验性深潜和纵向研究的证据表明，商业深潜者潜水对肺部有长期不良影响，如小气道疾病的发展和肺功能加速丧失。此外，越来越多的证据表明，使用自给式水下呼吸器（水肺）潜水可能与对肺功能的有害影响无关。尽管单次水肺潜水后肺功能的变化已被发现与浸入、环境低温和减压应激有关，但肺功能变化很小，临床意义不大。最近的证据表明，军事或休闲水肺潜水者的肺功能不会随时间加速丧失。因此，潜水对肺功能的影响很大程度上取决于与个体潜水暴露相关的因素。然而，在易感人群中，即使单次浅水肺潜水后也可能出现具有临床意义的肺功能恶化。
