潜艇潜航期间艇员电解质指标及红细胞压积、血色素的变化

Changes in electrolyte, hematocrit and hematochrome among the nuclear submarine crew during thesubmerged navigation

目的研究潜航期间潜艇艇员电解质指标及红细胞压积（HCT）、血色素（HGB）变化，分析其可能原因，为潜航期间潜艇艇员的微量元素摄入提供依据。方法采用i-STAT便携式手持血气分析仪对潜航期间42名潜艇艇员进行血清Na^＋、K^＋、Ca^2＋水平及HCT、HGB检测，观察不同时间点、年龄、战位、累计出海时间上述指标变化。结果（1）潜航第10天血清K^＋为（3．49±0．20）mmol／L，与潜航前（3．73±0．23）mmol/L比较，差异有统计学意义（P〈0．05）。潜航第30天为（1．19±0．06）mmol／L，与潜航前（1．05±0．11）mmol／L比较，差异有统计学意义（P〈0．01）；潜航第30天HCT、HGB[分别为（41．70±1．83）％、（14．19±0．62）g/L]与潜航前[（45．44±3．50）％、（15．46±1．18）g/L]比较，差异有统计学意义（P〈0．01）。（2）后舱战位受检者K^＋和游离Ca^2＋水平分别为（3．57±0．23）、（1．07±0．12）mmol／L，明显低于前舱战位[（3．72±0．21）、（1．15±0．08）mmol／L]，差异有统计学意义（P〈0．01、P〈0．05）；累计出海时间长的受检者HCT和HGB分别为（44±3．12）％、（15．0±1．13）g/L，与其他受检者[（42±2．08）％、（14．40±0．59）g／L]比较，差异有统计学意义（P〈0．05）。结论潜航期间核潜艇艇员低钾、低钙发生率较高。HCT和HGB均有下降趋势，应加强监测，采取干预措施，确保潜航艇员身体健康。

Objective To study changes in electrolyte and hematochrome among the nuclear submarine crew during the submerged navigation, to analyze possible reasons for these changes and also to provide scientific evidence for the ingestion of trace elements during submerged navigation. Methods （1） Measurement of the levels of serum Na± , K± , Ca^2± , HCT and HGB was made during submerged navigation in the 42 nuclear submariners by using the i-STAT portable handheld blood gas analyzer. （2） Changes in the above-mentioned indices were detected at different time points, and also in accordance with age, different battle stations and accumulated time at sea. Results （ 1 ） Serum K ± detected on the tenth day was （3.49 ± 0.20） mmol/L, which was significantly lower than that measured before submerged navigation （ 3.73 ± 0. 23 ） retool/ L（P 〈0.05）. Serum Ca2± detected on the 30th day was （1.19± 0.06） retool/L, which was significantly higher than that of the data measured before submerged navigation （ 1.05 ± 0. 11 ） mmol/L（ P 〈 0.01 ）. The levels of HCT and HGB detected on the 30th day were [（41. 70 ± 1. 83）%, （14. 19 ±0. 62） g/L] respectively, which were all significantly lower than those of the data measured before submerged navigation [（45.44±3.50）%, （15.46±1. 18）g/L] （P〈0.01） （P〈0.01）. （2） Serum K± and Ca2± of the submariners in the rear compartment battle stations were （3.57 ± 0.23 ） mmol/L and （1.07 ± 0.12 ） mmol/L respectively, which were all significantly lower than those of the submariners in the forward compartment battle stations [ （3.72 ± 0.21 ） mmol/L and （ 1.15 ±0.08 ） mmol/L ] （ P 〈 0.01, P 〈 0.05 ）. The levels of HCTand HGB in the submariners with longer cumulative time at sea were respectively （44 ± 3.12）% and （15.0± 1.13） g/L, which were all significantly higher than those of other submariners [ （42 ±2.08） % and （ 14.40 ± 0. 59 ） g/L ] （ P 〈 0. 05 ）. Conclusions During submerged navigation, incidence of hypokalemia and hypocalcemia was rather high among the nuclear submariner crew. The levels of HCT and HGB tended to decrease. Efforts should be made to intensify their detection and take preventive measures, so as to insure the health of submariners.