[严重潜水事故急性处理原则]。

L Lampl, G Frey, T Dietze, K H Bock
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引用次数: 0

摘要

通过25名患者(20名患者表现为减压病,5名患者患有肺部气压损伤并连续空气栓塞)在我们的设施中治疗,概述了严重潜水事故急性管理的基本知识。与普遍的观念相反,在明确的再压迫治疗之前,受到干扰的生命功能必须通过重症监护措施进行治疗。这些包括:(1)治疗继发于气泡产生的全身性或局部组织缺氧;(2)肺气压伤后穿刺(瓣膜性)气胸;(3)心脏或脊髓休克时血流动力学稳定;(4)改善流变状况。当生命功能不稳定或有危险时,这些患者不得在单一房间内运输。这种类型的腔室在病情恶化的情况下不会给病人留下任何通道。由于严重的潜水事故大多是重症监护医学与再压缩治疗紧密结合的问题,因此将再压缩方案与综合重症监护治疗持续整合是至关重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Principles of acute management of the severe diving accident].

The basics of the acute management of severe diving accidents are outlined by means of 25 patients (20 patients presented with decompression sickness, 5 suffered from a barotrauma of the lungs with consecutive air embolism) treated at our facilities. Contrary to widespread notion, disturbed vital functions have to be treated by intensive care measures, prior to the definite recompression therapy. These are: (1) Treatment of generalized or localized tissue hypoxia secondary to bubble-generation; (2) puncture of a (valvular-) pneumothorax after a pulmonary barotrauma; (3) haemodynamic stabilization when cardiac or spinal shock is present; (4) improvement of the rheological situation. When vital functions are unstable or endangered, these patients must not be transported in a monoplace chamber. This type of chamber does not leave any access to the patient in case of a deteriorating status. Since the severe diving accident mostly turns out to be a problem of intensive care medicine in close combination with the recompression therapy, the continuous integration of the recompression protocol with a comprehensive intensive care therapy is considered crucial.

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