模拟153m深度快速上浮脱险的医学保障研究  

Research on the 153 m simulated air-breathing fast buoyancy ascent escape method

作　　者：王文波[1] 方以群[1] 张和翔[1] 于峰涛[1] 刘四辈[1] 顾心清[1] 胡明洋[1] 张剑[1] 顾靖华[1] 张捍东[1] 杨涛[1] 许骥[1] 李慈[1] 刘平小[1] 潘令松[1] 唐亦奇[1] 

机构地区：[1]海军医学研究所,上海200433

出　　处：《中华航海医学与高气压医学杂志》2004年第3期129-133,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：全军"九五"医药卫生科研基金 (96L 0 0 3 )

摘　　要：目的　研究大深度快速上浮脱险时对机体的影响 ,制订、验证脱险方案和保障措施。方法　 7名潜艇艇员着加装应急呼吸装置的脱险服 ,在模拟脱险舱内进行快速上浮模拟脱险。实验分 7种深度 ,即分别为 3,10 ,6 0 ,80 ,10 0 ,12 0和 15 3m,最后完成 15 3m上浮脱险。按 PT=P0 × 2 t/n要求增压 ,n值分别为 2 0 ,15 ,12 ,8和 7,减压按 (2 .5～ 3.0 ) m/ s速率线性减压至水面。在实验前、后监测心前区血流中的 Doppler气泡音、脑电图、心电图、动态心电图、肺功能、尿液神经肽含量、临床医学观察和心理学测定。结果　 3～ 80 m每个深度各 7人次 ,10 0 m 5人次 ,12 0 m 4人次 ,15 3m 3人次 ,实验共进行 4 0人次。实验中出现 4人次的单侧鼓膜轻微充血 ;1人次 15 3m时出现 ECG的 ST段下移 1.6 m V,7h后 ST段仍下移 1.0 m V ,2 4 h后基本恢复。其它指标中有的指标变化差异有显著性 (P<0 .0 5或 P<0 .0 1) ,但仍属正常生理学变化范围。医学观察 1个月未发现任何临床改变 ,但实验时心理应激导致的指标改变应引起足够的重视。结论　制订的脱险方案、保障措施安全 ,切实可行 ,可操作性强。Objective To investigate the effects of great depth air breathing fast buoyancy ascent on the human body, to develop and verify the submarine escape profile and medical support measures. Methods Seven subjects wearing the submarine escape suits with emergency breathing apparatus conducted the fast buoyancy escapes in the escape tower. There were 7 depths, i.e. 3,10, 60, 80, 100, 120 and 153 m in the experiment, for which the escapes were compressed in accordance with the formula of P T= P o×2 t/n with the n value being 20, 15, 12, 8 and 7 respectively. And the escapees ascended to the surface in linear decompression at a rate of (2.5~3.0)m/s. Precordial Doppler bubble detection, EEG, ECG, Holter ECG, pulmonary function, neuropeptide content in urine, were measured or tested before and after the experiment. And clinical observation and psychological assessment were also made in the process. Results A total of 40 man time escape ascents were carried out in the experiment, in which 7 man time escape ascents were made from 3~80 m depths, 5 man time escape ascents from 100 m depth, 4 man time escape ascents from 120 m, and 3 man time escape ascents were made from 153 m. Slight congestion in unilateral eardrum occurred in the 4 escapes during the experiment. ST segment descending 1.6 mV after escape from 153 m was found in one escape, and 7 hours later the ST segment of ECG still descended by 1.0 mV, which became almost normal after 24 hours. There were some statistical differences in other physiological indices, which were within normal range ( P <0.01 or P <0.05). One month follow up reveals that there were no significant changes clinically. However, attention must be paid to the transient physiological changes induced by psychological stress during the experiment. Conclusions The escape profile developed and measures taken were practical, safe and highly manipulative.

关 键 词：医学保障 心电图 改变 实验 潜艇艇员 ST段下移 单侧 快速 线性 深度 

分 类 号：R84[医药卫生—航空、航天与航海医学]