Cockett A T, Pauley S M, Zehl D N, Pilmanis A A, Cockett W S
Arch Surg. 1979 Mar;114(3):296-301. doi: 10.1001/archsurg.1979.01370270066011.
Current concepts in the pathophysiology of decompression sickness are reviewed. Mild, moderate, and severe forms of this syndrome resulting from gaseous and lipid emboli are described. Therapy is aimed at restoring or specifically treating each alteration. Plasma volume deficit is restored by colloidal re-expansion. Decompression sickness is partially treated when recompression alone is used. Blood lipid alterations are managed by use of antilipemic agents. Dextran is mentioned. Divers at depths of 61 m display changes in hematocrit, platelet, and blood lipid profiles. Cord paralysis may occur from bubbles in the vena cava. Retrograde migration blocks the venous circulation of the spinal cord. Ultrasonic devices can detect "silent" bubbles during decompression. Recompression, when available, is a lifesaving treatment for diving accidents involving saturation diving. Air embolism is discussed. Monitoring emboli by EEG and fundoscopy are reported.
本文综述了减压病病理生理学的当前概念。描述了由气体和脂质栓子引起的该综合征的轻度、中度和重度形式。治疗旨在恢复或特异性治疗每种改变。通过胶体扩容来恢复血浆容量不足。仅使用再加压时，减压病可得到部分治疗。使用抗血脂药物来处理血脂改变。提到了右旋糖酐。在61米深度潜水的潜水员会出现血细胞比容、血小板和血脂谱的变化。腔静脉中的气泡可能导致脊髓麻痹。逆行迁移会阻断脊髓的静脉循环。超声设备可在减压过程中检测“无声”气泡。再加压在可行时是涉及饱和潜水的潜水事故的救命治疗方法。讨论了空气栓塞。报告了通过脑电图和检眼镜监测栓子的情况。
