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中华航海医学与高气压医学杂志
中华航海医学与高气压医学杂志

褚新奇

双月刊

1009-6906

zhhh@chinajournal.net.cn

021-81883316

200433

上海市翔殷路880号

中华航海医学与高气压医学杂志/Journal Chinese Journal of Nautical Medicine and Hyperbaric MedicineCSCDCSTPCD北大核心
查看更多>>1994年创刊，中国科学技术协会主管，中华医学会主办。本刊是我国航海医学领域、高压氧医学与潜水医学领域唯一的专业性科技核心期刊和统计源期刊。本刊已被美国《化学文摘》（CA）、俄罗斯《文摘杂志》（AJ）、国内各大数据库收录，主要刊发航海环境医学、潜水医学、航海临床医学、高压氧医学、航海医学保障与卫生防疫、航海医学心理学、航海人-机-环系统工程学、医学教育等方面的文章。主要读者对象为从事航海医学与高压氧医学治疗、教学、科研、管理等领域的高、中级人员。
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    高压氧联合丁苯肽及艾地苯醌治疗血管性痴呆的疗效及对氧化应激、认知功能的影响

    边亚礼杨艳双巩江华姚健...
    55-58页
    查看更多>>摘要：目的 探索高压氧联合丁苯肽及艾地苯醌治疗血管性痴呆患者的疗效及对氧化应激、认知功能的影响。 方法 前瞻性选取2016年6月至2021年6月衡水市人民医院全科医学科收治的300例血管性痴呆患者，根据治疗方法分为对照组和观察组，每组150例。对照组患者采用丁苯肽及艾地苯醌治疗，观察组患者采用高压氧联合丁苯肽、艾地苯醌治疗。治疗3个月后，比较2组患者的血清超氧化物歧化酶（SOD）、丙二醛（MDA）、过氧化脂质（LPO）水平和疾病缓解率。比较2组患者治疗前后的简易精神状态（MMSE）量表评分。比较2组患者治疗期间转氨酶轻度升高、头晕、皮疹、胃肠道反应等不良反应发生情况。 结果 治疗后，观察组患者血清SOD、MDA、LPO的改善情况优于对照组，差异有统计学意义（P<0.001）。观察组患者治疗4、8、12周后的疾病缓解率均高于对照组，差异有统计学意义（P<0.01）。与治疗前比较，2组患者治疗后的MMSE评分均升高，且观察组高于对照组，差异有统计学意义（P<0.001）。2组患者的不良反应发生率比较差异无统计学意义（P>0.05）。 结论 高压氧联合丁苯肽、艾地苯醌治疗血管性痴呆，可改善氧化应激，提高患者的认知功能。 Objective To explore the efficacy of hyperbaric oxygen（HBO）therapy combined with butylbenzene peptide and idebenone on vascular dementia and its effects on oxidative stress and cognitive function. Methods A total of 300 patients with vascular dementia admitted to the Department of General Medicine of Harrison International Peace Hospital from June 2016 to June 2021 were prospectively selected and divided into control group and observation group，with 150 cases in each group. The patients in the control group received treatment with butylbenzene peptide and idebenone，while the patients in the observation group received HBO therapy combined with butylbenzene peptide and idebenone. After three months of treatment，the serum levels of superoxide dismutase（SOD），malondialdehyde（MDA），and lipid peroxidation（LPO）as well as the disease remission rate were compared between the two groups. The Mini-Mental State Examination（MMSE）scores of the patients before and after treatment were compared. The occurrence of adverse reactions，such as mild elevation of aminopherase，dizziness，rash，and gastrointestinal reactions during the treatment period，were compared between the two groups. Results After treatment，the serum levels of SOD，MDA，and LPO were significantly improved in the observation group than those in the control group（P<0.001）. The disease remission rates in the observation group after 4 weeks，8 weeks，and 12 weeks of treatment were significantly higher than those in the control group（P<0.01）. Compared with before treatment，the MMSE score of both groups increased after treatment，and the score of the observation group was higher than that in the control group，all the differences were statistically significant（P<0.001）. There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）. Conclusion HBO therapy combined with butylbenzene and idebenone can improve oxidative stress and enhance cognitive function in patients with vascular dementia.

    高压氧丁苯肽艾地苯醌血管性痴呆氧化应激认知功能

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    海勤人员高尿酸血症和痛风的发生情况及影响因素分析

    魏金凤刘武岩姜梅刘继良...
    59-62页
    查看更多>>摘要：目的 探讨海勤人员高尿酸血症（HUA）和痛风的发生情况及其影响因素。 方法 收集2017年1月至2022年12月入住联勤保障部队北戴河康复疗养中心康复疗养的海勤人员1 462例，经临床确诊HUA患者321例，包括无症状HUA患者279例为HUA组，痛风42例为痛风组，其余血尿酸（SUA）正常的1 141例为正常组。依据年龄分为≤30岁、31～40岁和>40岁3个年龄段，比较其HUA和痛风的发生情况。统计3组人群年龄、SUA、体重指数（BMI）、腰臀比（WHR）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、尿素氮（BUN）、血肌酐（SCr）、收缩压（SBP）、舒张压（DBP）等数据，并分析HUA海勤人员SUA水平与上述临床指标的相关性。 结果 31～40岁、>40岁年龄段海勤人员HUA和痛风发生率均明显高于≤30岁（P<0.01）。HUA组和痛风组患者年龄、SUA、BMI、WHR、BUN、SCr、TG、TC、LDL、SBP、DBP较正常组明显增高，HDL-C明显降低；痛风组患者年龄、SUA、TG、LDL-C、DBP较HUA组明显增高（P<0.05或P<0.01）。HUA海勤人员SUA水平与年龄、BMI、WHR、SCr、TG、TC、LDL-C和DBP呈正相关（P<0.05或P<0.01）。 结论 海勤人员特定的环境因素易导致HUA、痛风的发生，HUA海勤人员SUA水平与年龄、BMI、WHR、SCr、TG、TC、LDL-C和DBP等临床指标密切相关。 Objective To study the incidence and influencing factors of hyperuricemia（HUA）and gout in naval officers and sailors. Methods A total of 1665 naval officers and sailors admitted to Beidaihe Rehabilitation and Recuperation Center of PLA from January 2017 to December 2022 were selected. Among them，321 were diagnosed as HUA；279 asymptomatic HUA patients were assigned into HUA group and 42 HUA patients with gout were assigned into gout group，and the remaining 1141 patients with normal serum uric acid（SUA）were assigned into control group. The incidences of HUA and gout were compared in three age groups：≤30 years old，31 to 40 years old，and >40 years old. The data of age，SUA，body mass index（BMI），waist-hip ratio（WHR），triglyceride（TG），total cholesterol（TC），high-density lipoprotein cholesterol，low-density lipoprotein cholesterol，blood urea nitrogen（BUN），serum creatinine（SCr），systolic blood pressure（SBP），and diastolic blood pressure（DBP）of the three groups were recorded，and the correlation between SUA level of naval officers and sailors with hyperuricemia and the above-mentioned clinical indicators was analyzed. Results The incidences of HUA and gout in the naval officers and sailors aged from 31 to 40 years old and over 40 years old were all significantly higher than those under 30 years old（P<0.01）. Compared with the control group，age，SUA，BMI，WHR，BUN，SCr，TG，TC，LDL，SBP，and DBP in the HUA group and the gout group were all increased significantly，while HDL-C was decreased significantly；compared with the HUA group，age，SUA，TG，LDL-C，and DBP in the gout group were increased significantly（P<0.05 orP<0.01）. The level of SUA in the naval officers and sailors with HUA was positively correlated with age，BMI，WHR，Scr，TG，TC，LDL-C，and DBP（P<0.05 orP<0.01）. Conclusion Among naval officers and sailors，hyperuricemia and gout are easily caused by specific environmental factors，and their serum uric acid levels are closely related to the clinical indicators such as age，BMI，WHR，SCr，TG，TC，LDL-C，and DBP.

    高尿酸血症海勤人员痛风血尿酸

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    2022年东部战区某舰艇支队官兵近视矫正手术情况调查分析

    叶霞赵娜吴建国张寓景...
    63-68页
    查看更多>>摘要：目的 调查分析2022年东部战区某舰艇支队官兵的近视矫正手术情况，为保障官兵视觉健康及部队战斗力提供依据。 方法 2022年3-5月采用目的抽样法对东部战区某舰艇支队246名官兵进行问卷调查。问卷包括个人基本信息和眼表疾病指数（QSDI）量表，同时结合视力检测、电脑验光、裂隙灯检查、泪液分泌量（Schirmer Ⅰ）、泪膜破裂时间（BUT）、角膜荧光素染色（FL）等临床检查结果，将调查对象分为正常视力组、佩戴框架眼镜组、行近视矫正术组，其中行近视矫正术组再以手术方式、术前屈光度数分组，对其眼部情况进行统计分析。 结果 被调查的246例官兵中，72例（144眼，29.3%）曾行近视矫正手术，其中飞秒激光小切口基质透镜取出术（SMILE）40例（80眼，55.6%）、飞秒激光辅助的LASIK术（FS-LASIK）22例（44眼，30.6%）、准分子激光原位角膜磨镶术（LASIK）7例（14眼，9.7%）、有晶状体眼后房型人工晶状体植入术（ICL）3例（6眼，4.2%）；手术组干眼症高危率明显高于正常视力组和佩戴框架眼镜组（P<0.01），SMILE组与FS-LASIK组术后干眼高危率差异有统计学意义（P<0.05）。低度近视组（12例）和中高度近视组（60例）术后出现干涩、阅读疲劳感、夜视力下降、眩光及重影的发生率差异有统计学意义（P<0.05）；未手术组和SMILE、FS-LASIK、LASIK手术组Schirmer Ⅰ、BUT、FL检查结果差异无统计学意义（P<0.05）；LASIK组术后屈光回退发生率（14.29%）高于SMILE组（3.40%）、FS-LASIK组（4.54%），差异有统计学意义（P<0.05）。 结论 部队官兵近视矫正手术已由以LASIK为主转变为以SMILE为主，有助于减少术后干眼症及严重眼外伤后角膜瓣并发症的发生率。 Objective To investigate and analyze the current status of refractive vision correcting surgery in officers and sailors of a flotilla of the Eastern Theater Command in 2022，so as to provide a scientific basis for supporting their visual health and promoting combat effectiveness of the troop. Methods A questionnaire survey，which included demographic data and ocular surface disease index（QSDI），was conducted in officers and soldiers of a flotilla of the Eastern Theater Command. The participants were divided into normal vision group，glasses wearing group，and refractive vision correcting surgery group，according to the results of vision testing，computerized optometry，slit lamp examination，Schirmer test of tear fluid volume（Schirmer I），tear film break-up time（BUT），corneal fluorescein staining（FL），and other clinical examinations. Then，those who received refractive vision correcting surgery were further divided into subgroups according to surgical modality and preoperative diopter. The results were statistically analyzed by comparing the ocular conditions. Results Among the 246 participants，72 cases（144 eyes）received refractive vision correcting surgery，accounting for 29.3%. Among them，femtosecond laser small-incision lenticule extraction（SMILE）was performed in 40 cases（80 eyes，55.6%），Femtosecond Laser-Assisted in situ Keratomileusis（FS-LASIK）in 22 cases（44 eyes，30.6%），Laser-Assisted in Situ Keratomileusis（LASIK）in 7 cases（14 eyes，9.7%），and posterior chamber phakic intraocular implantable collamer lens（ICL）in 3 cases（6 eyes，4.2%）. In the meantime，the high-risk rate of dry eye in the refractive vision correcting surgery group was significantly higher than those in the normal vision group and the glasses wearing group（P<0.01）. In addition，the difference of high-risk rates of dry eye between the post-SMILE operation subgroup and the post-FS-LASIK operation subgroup was also statistically significant（P<0.05）. Before surgery，moderate myopia were 56 cases（112 eyes，77.8 %）accounted for the highest percentage. Low myopia（12 cases）and moderate-high myopia（60 cases）showed statistically significant differences in the proportions of postoperative dry eye，reading fatigue，night vision decrease，glare，and ghosting（P<0.05）. There was no statistically significant difference in the results of Schirmer I，BUT，and FL examinations among the normal vision group，and the subgroups of SMILE operation，FS-LASIK operation，and LASIK operation. Conclusion The main modality of refractive vision correcting surgery has changed from LASIK to SMILE among troopers，which helps reduce the incidences of post-operative complications such as dry eye and corneal flap.

    东部战区舰艇官兵近视矫正手术视觉健康

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    高压氧联合乳果糖及益生菌治疗对老年轻微型肝性脑病患者肝功能及认知能力的影响

    杨孜崔永辉李知翰郑紫恒...
    69-72页
    查看更多>>摘要：目的 探讨高压氧联合乳果糖及益生菌治疗对老年轻微型肝性脑病患者肝功能及认知能力的影响。 方法 选取2019年8月至2021年8月商丘市第一人民医院消化内科收治的92例老年轻微型肝性脑病患者作为研究对象，按照随机数字表法分为对照组（乳果糖联合益生菌治疗）与观察组（高压氧联合乳果糖及益生菌治疗），每组46例。对比2组患者的肝功能［丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转移酶（GGT）、总胆红素（TBil）］、认知能力［简易精神状态评价量表（MMSE）、改良长谷川痴呆量表（HDS-R）］、内毒素、血氨水平和肠道菌群（双歧杆菌、乳酸杆菌、大肠埃希菌）计数。 结果 与治疗前比较，治疗后2组患者的肝功能、认知能力、内毒素、血氨、肠道菌群计数明显改善（P<0.05或P<0.001）；治疗后观察组患者的AST、GGT、TBil、内毒素、血氨水平和大肠埃希菌计数明显低于对照组（P<0.05或P<0.001），而认知能力评分、双歧杆菌计数高于对照组（P<0.05或P<0.01）。 结论 高压氧联合乳果糖及益生菌治疗有利于改善老年轻微型肝性脑病患者的肝功能和认知能力，纠正肠道菌群失调。 Objective To investigate the effects of hyperbaric oxygen therapy combined with lactulose and probiotics on liver function and cognitive ability in old patients with minimal hepatic encephalopathy. Methods A total of ninety-two old patients with minimal hepatic encephalopathy admitted to the gastroenterology department of the First People's Hospital of Shangqiu from August 2019 to August 2021 were selected as the study objects，and were divided into control group（lactulose combined with probiotics）and observation group（hyperbaric oxygen therapy combined with lactulose and probiotics）by the random number table method，with 46 cases in each group. Liver function［alanine aminotransferase（ALT），aspartate aminotransferase（AST），γ-glutamyl transferase（GGT），total bilirubin（TBil）］，cognitive ability［Mini-mental state examination（MMSE），revised Hasegama’s Dementia Scale（HDS-R）］，endotoxin，blood ammonia，and the count of intestinal flora（bifidobacterium，lactobacillus，and escherichia coli）were compared between the two groups. Results Compared with those before treatment，liver function，cognitive ability，endotoxin，blood ammonia，and intestinal flora count of the two groups were significantly improved after treatment（P<0.05，P<0.001）. After treatment，the AST，GGT，TBil，endotoxin，blood ammonia，and escherichia coli counts of the observation group were lower than those of the control group（P<0.05，P<0.001），while the score of MMSE and bifidobacterium count were higher than those of the control group（P<0.05，P<0.01）. Conclusion Hyperbaric oxygen therapy combined with lactulose and probiotics can improve the liver function and cognitive ability of the elderly patients with minimal hepatic encephalopathy and correct the intestinal dysbiosis.

    高压氧乳果糖益生菌老年轻微型肝性脑病肝功能认知能力

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    特勤人员非酒精性肝功能异常情况及其影响因素分析

    骆芝英应英邬悦晨肖韵悦...
    73-76页
    查看更多>>摘要：目的 调查特勤人员非酒精性肝功能异常的发生情况及其影响因素。 方法 选取2018年7月至2021年1月在某疗养院疗养与体检的4 007名特勤人员作为研究对象，采用自制健康行为生活方式问卷调查表进行调查，收集其入院体检时的各项体检指标数据确定非酒精性肝功能异常的发生情况，采用Logistic回归分析非酒精性肝功能异常的影响因素。 结果 共回收有效问卷3 360份，有效率为83.9%，其中488人（14.52%）存在非酒精性肝功能异常情况。体重指数≥24组中非酒精性肝功能异常构成比（18.98%）明显高于体重指数<24组（10.57%），差异有统计学意义（χ2=47.664，P<0.01）；不同性别、年龄段、婚姻状况和学历分组中非酒精性肝功能异常构成比差异无统计学意义（P>0.05）。体重指数、饮食喜好油腻、饮食喜好硬、饮食喜好烟熏、吃饭过快、三酰甘油水平和低密度脂蛋白胆固醇水平增高与非酒精性肝功能异常的风险增加有关（P<0.01）；轻、中度运动和饮食喜好辣与非酒精性肝功能异常的风险降低有关（P<0.05或P<0.01）。 结论 特勤人员的非酒精性肝功能异常发生率较高，与体重指数、血脂水平、不良饮食喜好习惯密切相关。加强特勤人员的健康生活方式指导，促进其良好生活方式的养成，有助于降低非酒精性肝功能异常的发生率。 Objective To investigate the occurrence of non-alcoholic liver function abnormalities and their influencing factors in special duty servicemen. Methods A total of 4007 special duty servicemen who underwent rehabilitation and physical examination at a rehabilitation center from July 2018 to January 2021 were selected as the research subjects. A self-made questionnaire on health behavior and lifestyle was used for the investigation. The data of physical examination indicators on the day of medical examination were collected to determine the occurrence of non-alcoholic liver function abnormalities. Logistic regression analysis was used to analyze the influencing factors of non-alcoholic liver function abnormalities. Results A total of 3 360 valid questionnaires were collected，with an effective rate of 83.9%. Among them，488 individuals（14.52%）had non-alcoholic liver function abnormalities. The proportion of non-alcoholic liver function abnormalities in people with the body mass index（BMI）≥24 group（18.98%）was significantly higher than that in people with BMI<24 group（10.57%），and the difference was statistically significant（χ2 =47.664，P<0.01）. There was no significant difference in the proportion of non-alcoholic liver function abnormalities among different genders，age groups，marital status，and educational backgrounds（P>0.05）. The BMI，diet preference for greasy food，preference for hard food，preference for smoked food，fast eating，increased triglyceride level，and increased low-density lipoprotein（LDL）cholesterol level were related to an increased risk of non-alcoholic liver function abnormalities（P<0.01）. Light or moderate exercise and preference for spicy food were related to a decreased risk of non-alcoholic liver function abnormalities（P<0.05，P<0.01）. Conclusion Special duty servicemen have a high incidence of non-alcoholic liver function abnormalities，which are closely related to BMI，blood lipid level，and unhealthy dietary habits. Enhancing guidance on maintaining a healthy lifestyle and promoting the cultivation of good habits among special duty servicemen can effectively decrease the occurrence of non-alcoholic liver function abnormalities.

    特勤人员非酒精性肝功能异常体重指数

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    硫酸乙酰肝素与慢性心力衰竭患者心功能及高压氧治疗预后的关系

    张秀玲常志红郭庆平赵碧瑶...
    77-81页
    查看更多>>摘要：目的 探讨血清硫酸乙酰肝素（HS）水平与慢性心力衰竭（CHF）患者心功能及高压氧（HBO）治疗预后的关系。 方法 选取2020年12月至2021年12月长治医学院附属和济医院心血管内科收治的88例CHF患者作为观察组，入院后均予以常规对症治疗，然后予以HBO辅助治疗。并选取同期80例健康体检者作为对照组。随访半年，根据预后情况将CHF患者分为预后良好组（n=63）和预后不良组（n=25）。采用酶联免疫吸附法检测患者血清HS水平，采用单因素分析不同预后患者的临床资料及血清HS水平，然后应用多因素COX回归分析影响CHF患者HBO治疗预后不良的危险因素，再以预后为自变量，绘制接受者操作特征ROC曲线。 结果 观察组患者血清HS水平［（85.45±3.67）μg/L］明显高于对照组［（77.63±3.25）μg/L］，差异有统计学意义（t=14.561，P<0.01）。不同心功能分级CHF患者血清HS水平比较差异有统计学意义（F趋势=76.336，P<0.01）。ROC曲线分析结果显示，血清HS最佳截断值为85.46 μg/L时，预测CHF患者HBO治疗预后不良的曲线下面积为0.79［95%CI：（0.683～0.824）］，灵敏度和特异度分别为82.33%、72.45%。单因素分析检测结果显示，预后不良组和预后良好组患者年龄、收缩压、血清HS水平及左室射血分数（LVEF）比较差异有统计学意义（P<0.01）；多因素COX回归分析结果显示，年龄≥70岁、LVEF<45%、血清HS≥85.46 μg/L是CHF患者HBO治疗预后不良的独立危险因素（OR>1，P<0.05）。 结论 血清HS水平随着CHF患者心功能分级的增加而逐渐升高，且与HBO治疗预后密切相关。 Objective To investigate the relationship between serum heparan sulfate （HS） level and cardiac function and the prognosis after hyperbaric oxygen （HBO） therapy in patients with chronic heart failure （CHF）. Methods A total of 88 CHF patients admitted to the Department of Cardiovascular Medicine of Heji Hospital affiliated to Changzhi Medical College from December 2020 to December 2021 were selected into observation group. They were given conventional symptomatic treatment upon admission， followed by HBO therapy. Another 80 healthy individuals who underwent physical examinations during the same period were selected into control group. A six-month follow-up was conducted， and based on the prognosis， the CHF patients were divided into good prognosis group （n=63） and poor prognosis group （n=25）. Enzyme-linked immunosorbent assay was used to measure the serum HS levels in the patients. Clinical data and serum HS levels of patients with different prognoses were analyzed using univariate analysis， and multiple-factor Cox regression analysis was employed to identify risk factors affecting the poor prognosis of HBO therapy in CHF patients. Receiver Operating Characteristic （ROC） curve was generated using prognosis as an independent variable. Results The serum levels of HS in the observation group［（85.45 ± 3.67） μg/L］were significantly higher than those in the control group［（77.63 ± 3.25） μg/L］， with statistically significant differences （t=14.561， P<0.01）. There were statistically significant differences among serum HS levels of CHF patients with different grades of cardiac function （F=76.336， P<0.01）. The ROC curve analysis showed that the optimal cutoff value for serum HS was 85.46 μg/L. The area under the curve （AUC） for predicting poor prognosis of HBO therapy in CHF patients was 0.79［95%CI： 0.683-0.824）］， with the sensitivity of 82.33% and the specificity of 72.45%. Univariate analysis revealed significant differences in age， systolic blood pressure， serum HS level， and left ventricular ejection fraction （LVEF） between the poor prognosis group and the good prognosis group （P<0.01）. Multivariate Cox regression analysis revealed that age≥70 years， LVEF<45%， and serum HS≥85.46 μg/L were the independent risk factors for poor prognosis of HBO therapy in the two groups （OR>1， P<0.05）. Conclusion Serum HS level gradually increases with the deterioration of cardiac function grade in CHF patients， which are closely related to the prognosis of HBO therapy.

    硫酸乙酰肝素慢性心力衰竭心功能高压氧治疗预后

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    东北三省居民迁居海南省初期中暑先兆率及影响因素调查分析

    雷忠卫方凡夫王宁李柏...
    82-85页
    查看更多>>摘要：目的 调查分析部分东北三省居民迁居海南省初期的中暑先兆率及影响因素，供今后迁入热带环境的居民和派遣至热带海域的海军官兵预防中暑和中暑先兆提供参考。 方法 制作中暑先兆率和影响因素调查表，通过电话或网络通信方式对2010-2020年迁居海南省的202名东北三省居民、57名北方非东北居民、92名海南本地居民进行调查，并分析中暑先兆发病原因和影响因素。 结果 东北三省居民的中暑先兆率为11.4%，其中迁入前规律锻炼者（每周锻炼3次或3次以上）中暑先兆率低于未规律锻炼者（P<0.05），有饮凉茶习惯者（每周饮凉茶3次或3次以上）中暑先兆率低于无饮凉茶习惯者（P<0.05）。 结论 坚持规律锻炼和饮凉茶有利于迁入热带地区的居民和派遣至热带海域的海军官兵预防中暑和中暑先兆。 Objective To investigate and analyze the incidence of premonitory heatstroke and influencing factors of migrants from northeast China to Hainan province，so as to provide reference to prevent premonitory heatstroke and heatstroke among inhabitants migrating to tropical areas and naval officers and sailors dispatched to tropical seas in the future. Methods A survey on the incidence of premonitory heatstroke and influencing factors was made among 202 residents from the three provinces in northeast China and 57 from northern China other than the three provinces who moved to Hainan province from 2010 to 2020，and 92 residents of Hainan Province origin were investigated by telephone or Internet，and the causes and influencing factors of premonitory heatstroke were analyzed. Results The incidence of premonitory heatstroke of migrants from the three northeast provinces was 11.4%. Among the migrants，those who exercised regularly before migration（3 or more times per week）had lower incidence than those who didn’t（P<0.05），those who had the habit of drinking herbal tea（3 or more times per week）had lower incidence than those who didn’t（P<0.05）. Conclusion Doing exercise regularly and drinking herbal tea can prevent premonitory heatstroke and heatstroke in the people migrating to tropical areas and naval officers and sailors dispatched to tropical seas.

    中暑先兆中暑发病率影响因素

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    基于一体化护理管理模式下高压氧联合新辅助化疗对口腔癌患者临床疗效及预后复发的影响

    杨海鸥胡海华李萌方燕...
    86-90页
    查看更多>>摘要：目的 探究基于一体化护理管理模式下高压氧联合新辅助化疗对口腔癌患者临床疗效及预后复发的影响。 方法 收集2017年3月至2020年12月首都医科大学附属北京同仁医院确诊为口腔癌患者100例作为研究对象。按照随机数字表法分为对照组和联合组，每组50例。对照组在基于一体化护理管理模式下联合新辅助化疗方案进行干预，联合组在对照组治疗的基础上予以高压氧治疗。采用酶联免疫吸附法检测患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-2、IL-6的表达水平；采用流式细胞术检测患者外周血CD3、CD4、CD8的百分比；采用实体瘤疗效评价标准评价口腔癌患者的临床疗效，并统计患者治疗过程中不良反应及复发率。 结果 联合组治疗总有效率（60.0%）明显高于对照组（40.0%），联合组患者不良反应发生率（38.0%）明显高于对照组（20.0%），联合组患者治疗后2年内复发率（14.0%）明显低于对照组（26.0%），差异均有统计学意义（P<0.05）。联合组患者治疗后血清TNF-α、IL-2、IL-6水平明显低于对照组（P<0.01）。联合组患者治疗后外周血CD3、CD4百分比明显高于对照组，CD8百分比明显低于对照组（P<0.05）。 结论 基于一体化管理模式下采用高压氧联合新辅助化疗能提高口腔癌患者的治疗依从性，增强机体的免疫功能，对减少口腔癌患者不良反应及预后复发具有较好的作用。 Objective To study the clinical efficacy of hyperbaric oxygen combined with neoadjuvant chemotherapy on patients with oral cancer and its influence on recurrence based on integrated nursing management model. Methods A total of 100 patients diagnosed as oral cancer in Beijing Tongren Hospital affiliated to Capital Medical University from March 2017 to December 2020 were collected as the research subjects and divided into control group and combination group according to the random number table method，with 50 cases in each group. The control group was received neoadjuvant chemotherapy based on the integrated nursing management model，and the combination group was given hyperbaric oxygen therapy on the basis of the treatment of the control group. Enzyme-linked immunosorbent assay was used to detect the expression levels of tumor necrosis factor-α（TNF-α），interleukin-2（IL-2），and interleukin-6（IL-6）；flow cytometry was conducted to detect the proportion of CD3，CD4，and CD8 in peripheral blood of the patients. Response Evaluation Criteria in Solid Tumors（RECIST）was applied to evaluate the efficacy on the patients with oral cancer，and the incidence of adverse reactions during the treatment was also recorded. Results The total effective rate of the combination group（60.0%）was significantly higher than that of the control group（40.0%）；the incidence of adverse reactions in the combination group（38.0%）was significantly higher than that in the control group（20.0%）；the recurrence rate within two years after treatment in the combination group（14.0%）was significantly lower than that in the control group（26.0%），all differences were statistically significant（P<0.05）. After treatment，the serum levels of TNF-α，IL-2，and IL-6 in the combination group were significantly lower than those in the control group（P<0.01），and the proportions of CD3 and CD4 in the peripheral blood in the combination group were significantly higher than those in the control group，but the proportion of CD8 was significantly lower than that in the control group（P<0.05）. Conclusion Based on integrated management nursing model，hyperbaric oxygen combined with neoadjuvant chemotherapy can improve the treatment compliance in patients with oral cancer and enhance the immune function of the body，which has a good effect on reducing the incidence and recurrence rate of adverse reactions of the patients with oral cancer.

    口腔癌一体化护理管理高压氧新辅助化疗

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    冠心病经皮冠状动脉介入术后主要不良事件发生的影响因素分析

    孙莲青孙向华沈月娥韩雅琴...
    91-95页
    查看更多>>摘要：目的 探讨冠心病经皮冠状动脉介入术（PCI）后主要不良心血管事件（MACE）发生的影响因素。 方法 回顾性分析2021年5月至2022年5月上海交通大学医学院附属新华医院心血管内科择期进行冠心病PCI患者108例的临床资料。PCI术后24 h进行高压氧（HBO）辅助治疗，并随访6个月，根据患者是否发生MACE，将患者分为MACE组（n=36）和无MACE组（n=72）。采用全自动生化分析仪检测患者清晨空腹静脉血血脂水平；采用酶联免疫吸附法检测患者血清高敏C反应蛋白、肿瘤坏死因子-α、γ干扰素、白细胞介素-10、心肌营养素-1（CT-1）、血管细胞间黏附分子1（VCAM1）水平。分别于治疗前后应用彩色多普勒超声诊断仪测定颈动脉斑块面积和颈动脉内膜中层厚度。 结果 与治疗前比较，2组患者治疗后总胆固醇、三酰甘油、低密度脂蛋白胆固醇、CT-1、高敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-10、γ干扰素水平及颈动脉斑块面积、颈动脉内膜中层厚度均明显减少或降低，高密度脂蛋白胆固醇和VCAM1水平明显升高（P<0.01）。治疗后MACE组总胆固醇、三酰甘油、低密度脂蛋白胆固醇、CT-1、高敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-10、γ干扰素及颈动脉斑块面积、颈动脉内膜中层厚度明显低于无MACE组，高密度脂蛋白胆固醇、VCAM1水平明显高于无MACE组（P<0.01）。 结论 冠心病PCI术后辅助HBO治疗，通过调节血清CT-1、VCAM1水平，减轻患者机体炎症反应，降低血脂水平，减少颈动脉斑块面积，降低颈动脉内膜中层厚度，从而减少PCI术后MACE的发生。 Objective To explore the influencing factors of main adverse cardiac events（MACE）after percutaneous coronary intervention（PCI）in patients with coronary heart disease. Methods The clinical data of 108 patients with coronary heart disease undergoing elective PCI in the Department of Cardiovascular Medicine of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2021 to May 2022 were retrospectively analyzed. Hyperbaric oxygen（HBO）therapy was performed on 24 h after PCI，and the patients had been followed up for 6 months. According to the occurrence of MACE，the patients were divided into MACE group（n=36）and non-MACE group（n=72）. Automatic biochemical analyzer was used to detect the level of fasting venous blood lipid，and Enzyme-Linked Immunosorbent Assay was conducted to detect the levels of serum high-sensitive C-reactive protein，tumor necrosis factor-α，interferon gamma，interleukin-10，cardiotrophin-1（CT-1），and vascular cell adhesion molecule 1（VCAM1）. Color Doppler ultrasonography was applied to measure carotid plaque area and carotid intima-media thickness before and after treatment，respectively. Results After treatment，levels of total cholesterol，triglyceride，low-density lipoprotein cholesterol，CT-1，high-sensitive C-reactive protein，tumor necrosis factor-α，interleukin-10，and interferon gamma in the two groups were significantly decreased；carotid plaque area and carotid intima-media thickness in the two groups were significantly reduced；levels of high-density lipoprotein cholesterol and VCAM1 in the two groups were significantly increased（P<0.01）. The levels of total cholesterol，triglyceride，low-density lipoprotein cholesterol，CT-1，high-sensitive C-reactive protein，tumor necrosis factor-α，interleukin-10，and interferon gamma in the MACE group were significantly lower than those in the non-MACE group，and carotid plaque area and carotid intima-media thickness in the MACE group were significantly smaller than those in the non-MACE group，but the levels of high-density lipoprotein cholesterol and VCAM1 in the MACE group were significantly higher than those in the non-MACE group. Conclusion HBO therapy after PCI can reduce inflammatory response，blood lipid level，carotid plaque area，and carotid intima-media thickness by regulating the levels of serum CT-1 and VCAM1，thus providing a valuable evidence for the prevention and treatment of MACE after PCI.

    冠心病经皮冠状动脉介入术高压氧主要不良心血管事件

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    国产新型高压氧专用电控气动呼吸机运行稳定性的研究

    王丛薛连璧于秋红刘亚玲...
    96-100页
    查看更多>>摘要：目的 探讨国产新型高压氧（HBO）专用电控气动呼吸机在高气压环境中以压力控制模式（PCV）运行时的稳定性。 方法 将呼吸机气动部分与模拟肺连接安装于舱内，呼吸机电控部分与模拟肺数据采集电脑置于舱外，在PCV模式下根据预设吸气压力（PI）分5个预设水平（1.0、1.5、2.0、2.5、3.0 kPa），按舱内压力分为0.10 MPa组、0.15 MPa组、0.20 MPa组，采集气道峰压（Ppeak）、潮气量（VT）和分钟通气量（MV）；每组20个循环，比较各预设PI在3组中的参数的变化。 结果 随环境压力升高，各组预设PI中Ppeak、VT、MV均出现下降，差异均有统计学意义（均P<0.05），下降幅度<6%。 结论 国产高压氧专用电控气动呼吸机在HBO舱内（0.10～0.20 MPa）以PCV运行时随着舱内压力升高呼吸参数出现差异，但该变化在临床使用相对稳定范围内。 Objective To investigate the operation stability of a new type domestic electro-pneumatic ventilator during pressure-controlled ventilation（PCV）in hyperbaric oxygen（HBO）chamber. Methods The pneumatic part of the HBO ventilator and a test lung were connected and placed inside a hyperbaric chamber. The electric part of the ventilator was placed outside the chamber along with a computer connected with the test lung for real-time data collection. During the PCV，the inspiratory pressures（PI）were preset at five levels（1.0，1.5，2.0，2.5，and 3.0 kPa），under three different chamber pressures（0.10 MPa，0.15 MPa，and 0.20 MPa），respectively. The peak inspiratory pressure（Ppeak），the tide volume（VT），and the minute volume（MV）as displayed by the ventilator and the test lung were recorded at each level of PI for 20 cycles. The differences of the three groups of data were then compared and analyzed. Results As the chamber pressure increased，the Ppeak，VT，and the MV at each level of PI decreased within a narrow range（<6%），and the differences were statistically significant（P<0.05）. Conclusion When the HBO electro-pneumatic ventilator working in PCV mode in a HBO chamber（0.10–0.20 MPa），its ventilation indexes can have some changes as the pressure increasing，but the changes are still within the relative stable range for clinical application.

    高压氧呼吸机间歇正压通气呼吸力学气道阻力

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