应用医用空气加压氧舱治疗Ⅰ型减压病探讨

A study of recompression treatment schedule for treating type Ⅰ decompression illness with medical hyperbaric chamber pressurized

目的应用医用空气加压氧舱实施德国BG1690《压缩空气疾病治疗手册》加压治疗表D2方案（0．12MPa表压、吸氧）治疗Ⅰ型减压病，观察其疗效。方法现场加压治疗组患者7例，医院加压治疗组患者5例，均从事隧道工程压缩空气环境作业执行规定减压程序后患I型减压病，根据加压治疗反应选用基本D2方案或延长D2方案。结果现场加压治疗组患者肌肉关节痛消除陕，平均加压治疗起效时间为（8．1±8．1）min，使用基本D2方案1次加压治疗治愈，平均加压治疗总时间为（150．0±0．0）min；医院加压治疗组患者肌肉关节痛消除慢，平均加压治疗起效时间为（115．0±60．0）min，使用延长D2方案1次加压治疗治愈，平均加压治疗总时间为（270．0±0．0）min。现场加压治疗组的平均加压治疗起效时间和平均加压治疗总时间均明显短于医院加压治疗组，差异均统计学意义（P〈0．01）。结论D2方案的治疗压力为0．12MPa（表压），可使用医用空气加压氧舱实施治疗。Ⅰ型减压病患者于发病现场使用基本D2方案，送医院治疗的延误患者使用延长D2方案可取得满意疗效。

Objective To observe the therapic effects of the recompression treatment schedule D2 （breathing 100% oxygen at 0.12 MPa gauge pressure） on the type Ⅰ decompression illness （DCI） by hyperbaric chamber pressurized with air. Methods The recompression treatment schedule D2 was from the decompression treatment tables of 〈Leaflet for the Treatment of Illness in Compressed Air 〉 in Germany BGI690. Seven cases on work site group （work site group） and five cases in hospital （hospital group） were treated using recomprcssion treatment. All cases suffered from type Ⅰ DCI after normal decompression procedures from working in compressed air in tunnel construction. These patients were treated with basic schedule D2 or extended schedule D2 according to the symptoms of the cases responded to recompression therapy. Results In the work site group, the pains of joints, arms and legs were released quickly, the therapic effects appeared at （8. 1±8.1 ）min, the cases were cured with a recompression therapy of basic schedule D2, the total mean time of treatment was （150±0.0） min. In the hospital group, the pains of joints, aims and legs disapeared slowly, the therapic effects appeared at （115.0±60.0） rain, the cases were cured with a recompession therapy of extended schedule D2, the total mean time of treatment was （270.0±0.0） min, which was significantly longer than that in the work site group （P〈0.01）. Conclusions The treatment pressure is 0.12 MPa（gauge pressure） in schedule D2 with medical hyperbaric chamber pressurized with air,which can be used for treatment of type Ⅰ DCI, the curative effects in the work site group are better than those in the hospital group.