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目的探讨飞行中高空迅速减压飞行人员的临床诊治经验和医学鉴定方法。方法回顾分析近10年来空军发生的5起19人次高空迅速减压病例资料,暴露高度为8300至10000m。结果①5起高空迅速减压中有3起10人(A组)返航后未经休息吸氧和高压氧治疗,其中7人发生了Ⅱ型高空减压病,发病率为70%,另2起9人(B组)返航后及时休息吸氧并送就近医院作高压氧治疗,均未发生高空减压病,两组高空减压病发生率有显著性差异(P<0.01)。②两组对比分析发现,除了已明确的迅速减压时的高度外,在本组资料中个体敏感性、减压后高空缺氧以及空中和返航后的处置是否得当是影响发病的重要因素。③所有发病者经治疗均重返飞行岗位,但发病后治疗不适当或飞行员出现心理障碍会延长康复时间。结论高空迅速减压可对飞行人员造成显著的心理和生理影响,并且发生高空减压病的危险很大,减压后空中及返航后处置是否得当是影响病情发展的重要因素。
Objective To explore the clinical diagnosis and treatment and the medical appraisal method of the rapid decompression flight personnel in flight. Methods A retrospective analysis of the air force in the past 10 years occurred in 19 cases of rapid decompression of 19 cases of altitude data, the exposure height of 8300 to 10000m. Results ① Five of 10 patients (A group) returned to the air without decompression and hyperbaric oxygen therapy after resuscitation. Among them, 7 patients developed type Ⅱ altitude decompression sickness, the incidence was 70%, and the other 2 Nine patients (group B) returned to the hospital and took oxygen therapy immediately after they returned home. No hyperbaric decompression sickness occurred. The incidence of hypertension was significantly different between the two groups (P <0.01). ② The two groups of comparative analysis found that, in addition to the rapid decompression has been clear, the individual sensitivity in this group of information, hypobaric hypoxia after decompression and air and return after improper disposal is an important factor affecting the incidence. (3) All patients who have been sent back to their posts after treatment, but the improper treatment after the onset of illness or psychological disorder in pilots may prolong the recovery time. Conclusions Rapid decompression at high altitude may cause significant psychological and physiological effects on pilots, and the risk of altitude decompression sickness is very high. Whether the airborne and decompression post-decompression treatments are appropriate or not is an important factor influencing the progression of the disease.