浅深度饱和后模拟150 m快速上浮脱险对山羊血细胞及凝血功能的影响

Effects of simulated fast buoyancy escape from 150 meters on blood cells and coagulation in goats following shallow water saturation exposure

目的：探索浅深度饱和后模拟150 m快速上浮脱险对山羊血细胞及凝血功能的影响。方法成年健康山羊12只，按数字表法随机分为7 m组和12 m组，每组6只。分别在该深度压力下暴露20 h，呼吸空气，之后立即实施150 m快速上浮脱险，出舱后观察动物体征、心前区气泡音，记录减压病（decompression sickness，DCS）发病率和死亡率；在出舱后0．5 h和2 h分别采静脉血，进行血细胞计数和凝血功能检测。结果7 m组未发生DCS和其他损害；12 m组发生1例肺气压伤，6例轻型DCS。2组动物均无死亡。与进舱前相比，7 m组出舱后凝血酶时间（thrombin time，TT）延长[进舱前为（17．27±0．93）s、出舱后0．5 h为（18．38±0．77）s、出舱后2 h为（18．42±0．99）s]、纤维蛋白原（fibrinogen，FIB）含量增高[进舱前为（2．36±0．53）g／L、出舱后0．5 h为（2．63±0．69）g／L、出舱后2 h为（2．67±0．65） g／L]，差异有统计学意义（P＜0．05）。12 m组在出舱后0．5 h PT值明显缩短，与进舱前相比差异有统计学意义（P＜0．05），在出舱后2 h 又恢复；12 m组出舱后2 h 活化部分凝血活酶时间（activated partial thromboplastin time，APTT）、TT均延长，与进舱前比较差异有统计学意义（P＜0．05）。与7 m组相同时间比较，12 m组血清D-二聚体（D-dimer，D-D）含量在出舱后2 h时明显增高，差异有统计学意义（P＜0．05）。结论7 m和12 m饱和后再进行150 m快速上浮脱险，可引起机体凝血纤溶功能改变，可能发生轻型DCS。在12 m以浅饱和暴露后可视情况采用快速上浮脱险方式逃生。

[ Abstract] Objective To investigate the effects of simulated fast buoyancy escape from 150 meters （msw） on blood cells and coagulation in goats following shallow water saturation exposure. Methods Twelve adult male healthy goats were randomly divided into 2 groups： the 7-meter group and the 12-meter group, each consisting of 6 animals. The animals of the 2 groups breathing air were respectively exposed to the saturation pressures of 1.7 ATA （ 170 kPa） and 2.2 ATA （220 kPa） for 20 hours. Following saturation exposures, both groups underwent simulated fast buoyant escape from 150 msw. After the animals were surfaced and brought out of the chamber, clinical physical signs and pre-cordial bubble sound were closely observed, and morbidity and mortality of decompression sickness （DCS） were recorded. At hour 0.5 and 2 after they were out of the chamber, venous blood samples were collected for the measurement of blood cell counts as well as coagulation. Results No DCS and other injuries occurred in the animals of the 7-meter group, while in animals of the 12- meter group there were one case of pulmonary barotrauma and 6 cases of mild DCS. But there were no dead cases in both groups. As compared with that before compression[ （17.27 ＋ 0.93 ）sl, the thrombin time （TT） of the 7-meter group at hour 0.5 and 2 after they were out of the chamber [ （ 18.38 -＋0.77） s and（ 18.42 ＋ 0.99） s ] was all prolonged. The levels of fibrinogen （FIB） before compression, at hour 0.5 and 2 after they were out of the chamber were respectively[ （2.36±0.53）g/L], [ （2.63 ±0.69） g/L] and [ （2.67 ±0.65）g/L]. Statistical significance could be noted, when comparisons were made between them（ P 〈 0.05 ）. TP of the 12-meter group at hour 0.5 was obviously shortened, and statistical difference was shown when compared with that before compression（P 〈 0.05 ）. Nevertheless, TF level was recovered at hour 2 after they were out of the chamber. At hour 2 after the animals were out of the chamber, the activated partial thromboplastin time （APTT）and TT of the 12-meter group were all prolonged, and statistical significance could be found, when they were compared with that before compression （P 〈 0.05 ）. The level of D-dimer （D-D）for the 12-meter group at hour 2 after termination of exposure was significantly increased, as compared with that of the 7-meter group at the same time point. Statistical significance could be seen, when comparisons were made between them （ P 〈 0.05 ）. Conclusions The study indicated that fast buoyancy escape from 150 meters following saturation exposure at depths of 7 and 12 meters could induce transient changes in coagulation and fibrinolysis activation, and might result in mild DCS. It was possible that fast buoyancy escape might be applied following saturation exposure at a depth shallower than 12 meters, which would of course depend on the situation.