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目的介绍国内外高空减压病(ADS)诊断和治疗进展情况,以期能对提高 ADS 临床处置水平有所帮助。资料来源与选择国内外该领域的相关文献。资料引用引用国内外参考文献26篇。资料综合减压病缺乏特异性的客观诊断指标,症状学表现仍是减压病诊断的主要依据,但不同要素的重要性不同。由于神经组织易产生原发性气泡,故静脉气泡尚不能作为预测神经型ADS 的有效指标。对卵圆孔未闭在 ADS 发病中的作用值得临床航空医学工作者进行更多的研究。单纯连续呼吸纯氧对 ADS 的治疗有一定作用,但对实际作战飞行条件下发病者治疗效果的评价还需要慎重考虑。加压治疗方案的改进主要是考虑降低治疗压力和减少治疗时间。针对一些延迟治疗的病例,对现行的美国海军加压治疗方案尚需进一步完善。结论虽然大多数 ADS 能够完全治愈,但由于一些延迟治疗的以及神经型 ADS 有可能遗留难治性的后遗症,因此在诊断和治疗方面仍需给予充分重视。造成 ADS 诊断技术停滞不前的主要原因是对 ADS 基础研究的缺乏,只有深入认识生物体内气泡生成和气泡引起一系列病理变化的细节才能为 ADS 的诊断和治疗提供更加有效的方法。
Objective To introduce the diagnosis and treatment of altitude sickness (ADS) at home and abroad in order to improve the clinical treatment of ADS. Sources and selection of relevant literature in this field at home and abroad. Reference cited 26 references at home and abroad. Information decompression sickness lack of specific objective diagnostic indicators, the performance of symptoms is still the main basis for the diagnosis of decompression sickness, but different elements of different importance. Because nerve tissue is prone to produce primary air bubbles, venous air bubbles are not yet available as effective predictors of neurological ADS. The role of patent foramen ovale in the pathogenesis of ADS deserves more research by clinical aviation medical workers. Pure continuous breathing of pure oxygen has some effect on the treatment of ADS, but the evaluation of the therapeutic effect of the disease under actual combat flight conditions needs careful consideration. Improvements in pressurized treatment are mainly considered to reduce the treatment pressure and reduce treatment time. For some delayed treatment of cases, the current US Navy pressure treatment programs need to be further improved. Conclusions Although most ADS can be completely cured, some delayed treatment and neurological ADS may still give rise to refractory sequelae, so adequate attention should be paid in diagnosis and treatment. The main reason for the stagnation of ADS diagnostic technology is the lack of basic research on ADS. Only in-depth understanding of the details of a series of pathological changes caused by the formation of air bubbles and the bubbles in vivo can provide a more effective method for the diagnosis and treatment of ADS.