哮喘联盟

   摘要
   本文旨在对哮喘和SCUBA（自持式水下呼吸装置）潜水的现有研究进行综述。采用哮喘、过敏和SCUBA潜水作为关键词，在MEDLINE数据库中检索哮喘和SCUBA潜水的相关同行评议文献。美国现有超过900万的SCUBA潜水者。SCUBA潜水是一项危险运动。哮喘患者可发生支气管痉挛，导致气道堵塞。气道堵塞可能位于远端气道抑制气体交换。远端气道过度扩张可能导致肺气压伤，也存在气体栓塞的风险。哮喘潜水者也可能吸入海水，引起支气管痉挛。他们的氧气瓶内被花粉污染可能加重患者的变应性哮喘。潜水可能损害哮喘患者的肺功能。虽然SCUBA潜水存在风险，但是很多哮喘患者并未在潜水时发生严重潜水事件。对于哮喘患者的潜水评估主要集中于病史、肺功能、过敏源试验和支气管激发试验。对于想潜水的患者，他们的哮喘应该得到很好的控制，没有胸部症状。患者应该肺功能正常。一些潜水协会推荐哮喘患者应该成功完成支气管激发试验才能进行潜水，此外还指出运动、情绪和寒冷引起的哮喘也不应潜水。48小时内需要缓解药物治疗的哮喘患者也不应潜水。

 

（杨冬 审校）
Clin Rev Allergy Immunol. 2015 Feb 10. [Epub ahead of print]


 

SCUBA Diving and Asthma: Clinical Recommendations and Safety.

Coop CA1, Adams KE, Webb CN.

ABSTRACT
The objective of this article is to review the available studies regarding asthma and SCUBA (self-contained underwater breathing apparatus) diving. A literature search was conducted in MEDLINE to identify peer-reviewed articles related to asthma and SCUBA diving using the following keywords: asthma, allergy, and SCUBA diving. SCUBA diving is a popular sport with more than 9 million divers in the USA. SCUBA diving can be a dangerous sport. Bronchospasm can develop in asthmatic patients and cause airway obstruction. Airway obstruction may be localized to the distal airway which prevents gas elimination. Uncontrolled expansion of the distal airway may result in pulmonary barotrauma. There is also the risk of a gas embolism. Asthmatic divers can also aspirate seawater which may induce bronchospasm. Pollen contamination of their oxygen tank may exacerbate atopic asthma in patients. Diving may be hazardous to the lung function of patients with asthma. Despite the risks of SCUBA diving, many asthmatic individuals can dive without serious diving events. Diving evaluations for asthmatic patients have focused on a thorough patient history, spirometry, allergy testing, and bronchial challenges. For patients that wish to dive, their asthma should be well controlled without current chest symptoms. Patients should have a normal spirometry. Some diving societies recommend that an asthmatic patient should successfully pass a bronchial provocation challenge. Recommendations also state that exercise-, emotion-, and cold-induced asthmatics should not dive. Asthmatic patients requiring rescue medication within 48 h should not dive.

Clin Rev Allergy Immunol. 2015 Feb 10. [Epub ahead of print]