Boussuges A, Carturan D, Ambrosi P, Habib G, Sainty J M, Luccioni R
Service de Réanimation Médicale et d'Hyperbarie, Hôpital Salvator, Marseille, France.
Int J Sports Med. 1998 Jan;19(1):7-11. doi: 10.1055/s-2007-971871.
The aim of this study was to determine the utility of pulsed Doppler and 2D echocardiography for the detection and the quantification of circulating bubbles after decompression. Twenty-three sport divers performed 60 SCUBA dives (mean 32 msw). An evaluation of circulating bubbles was performed using 2D images one hour after diving. Circulating bubbles were also detected with pulsed Doppler. The sample volume was placed in the outflow area of the right ventricle 1-2 cm below the pulmonary valve. 2D echocardiography showed circulating bubbles in right cavities of the heart in 32 cases. Short axis parasternal view and right cavities long axis view were the best incidences. Pulsed Doppler confirmed the results in these 32 cases and detected circulating bubbles in seven other cases. Isometric contraction of muscle limb must be performed to increase the sensitivity of detection. The count of the bubbles may be evaluated when using a combination of Spencer's and Powell's grading. We conclude that 2D echocardiography is less accurate than pulsed Doppler in the detection of circulating bubbles after decompression. Further studies are needed to compare pulsed Doppler guided by 2D echocardiography to continuous Doppler for the detection of circulating bubbles.
本研究的目的是确定脉冲多普勒和二维超声心动图在检测减压后循环气泡及对其进行定量分析方面的效用。23名职业潜水员进行了60次水肺潜水（平均深度32米海水）。潜水1小时后，使用二维图像对循环气泡进行评估。同时也用脉冲多普勒检测循环气泡。取样容积置于肺动脉瓣下方1 - 2厘米处的右心室流出区域。二维超声心动图显示32例心脏右腔有循环气泡。胸骨旁短轴观和右腔长轴观发现气泡的发生率最高。脉冲多普勒在这32例中证实了结果，并在另外7例中检测到循环气泡。必须进行肢体肌肉等长收缩以提高检测的敏感性。使用斯宾塞（Spencer）和鲍威尔（Powell）分级相结合的方法时可评估气泡数量。我们得出结论，在检测减压后循环气泡方面，二维超声心动图不如脉冲多普勒准确。需要进一步研究以比较二维超声心动图引导下的脉冲多普勒与连续多普勒在检测循环气泡方面的差异。
