潜水对肺功能的短期和长期影响
2017/07/24
摘要
潜水环境对肺脏来说是一个考验，包括暴露于高压环境，气体交换特性和心血管对肺循环的影响。多种与潜水相关的因素可急剧地影响肺功能，并可能因重复暴露于潜水环境，效应逐渐累积，最终造成持续性影响。实验性深潜和纵向研究的证据表明潜水对商业潜水员肺部功能造成长期不良影响，比如小气道疾病的发生发展及肺功能下降的加速。此外，越来越多的证据表明潜水时携带的自携式水下呼吸器（水肺）可能对肺功能无不良影响。尽管研究人员发现单水肺潜水后，肺功能的改变与浸没、寒冷环境和减压负荷有关，但这些肺功能的改变很小且几乎没有临床意义。最新的证据指出，军事或休闲水肺潜水员的肺功能并没有随时间加速丧失。因此，潜水对肺功能的影响很大程度上取决于个人潜水暴露的因素。然而，在易感者中，即使是单次浮潜也有可能发生临床相关的肺功能恶化。
Short- and long-term effects of diving on pulmonary function.
Tetzlaff K, Thomas PS.
Abstract
The diving environment provides a challenge to the lung, including exposure tohigh ambient pressure, altered gas characteristics and cardiovascular effects on the pulmonary circulation. Several factors associated with diving affectpulmonary function acutely and can potentially cause prolonged effects that mayaccumulate gradually with repeated diving exposure. Evidence from experimentaldeep dives and longitudinal studies suggests long-term adverse effects of diving on the lungs in commercial deep divers, such as the development of small airwaysdisease and accelerated loss of lung function. In addition, there is anaccumulating body of evidence that diving with self-contained underwaterbreathing apparatus (scuba) may not be associated with deleterious effects on pulmonary function. Although changes in pulmonary function after single scuba dives have been found to be associated with immersion, ambient cold temperatures and decompression stress, changes in lung function were small and suggest a low likelihood of clinical significance. Recent evidence points to no accelerated loss of lung function in military or recreational scuba divers over time. Thus,
the impact of diving on pulmonary function largely depends on factors associated with the individual diving exposure. However, in susceptible subjects clinically relevant worsening of lung function may occur even after single shallow-water scuba dives.
Eur Respir Rev. 2017 Mar 29;26(143). pii: 160097. doi:10.1183/16000617.0097-2016.
潜水环境对肺脏来说是一个考验，包括暴露于高压环境，气体交换特性和心血管对肺循环的影响。多种与潜水相关的因素可急剧地影响肺功能，并可能因重复暴露于潜水环境，效应逐渐累积，最终造成持续性影响。实验性深潜和纵向研究的证据表明潜水对商业潜水员肺部功能造成长期不良影响，比如小气道疾病的发生发展及肺功能下降的加速。此外，越来越多的证据表明潜水时携带的自携式水下呼吸器（水肺）可能对肺功能无不良影响。尽管研究人员发现单水肺潜水后，肺功能的改变与浸没、寒冷环境和减压负荷有关，但这些肺功能的改变很小且几乎没有临床意义。最新的证据指出，军事或休闲水肺潜水员的肺功能并没有随时间加速丧失。因此，潜水对肺功能的影响很大程度上取决于个人潜水暴露的因素。然而，在易感者中，即使是单次浮潜也有可能发生临床相关的肺功能恶化。
(复旦大学附属中山医院呼吸科王晓岑摘译 杨冬审校)
（Eur Respir Rev. 2017 Mar 29;26(143). pii: 160097. doi:10.1183/16000617.0097-2016.）
（Eur Respir Rev. 2017 Mar 29;26(143). pii: 160097. doi:10.1183/16000617.0097-2016.）
Short- and long-term effects of diving on pulmonary function.
Tetzlaff K, Thomas PS.
Abstract
The diving environment provides a challenge to the lung, including exposure tohigh ambient pressure, altered gas characteristics and cardiovascular effects on the pulmonary circulation. Several factors associated with diving affectpulmonary function acutely and can potentially cause prolonged effects that mayaccumulate gradually with repeated diving exposure. Evidence from experimentaldeep dives and longitudinal studies suggests long-term adverse effects of diving on the lungs in commercial deep divers, such as the development of small airwaysdisease and accelerated loss of lung function. In addition, there is anaccumulating body of evidence that diving with self-contained underwaterbreathing apparatus (scuba) may not be associated with deleterious effects on pulmonary function. Although changes in pulmonary function after single scuba dives have been found to be associated with immersion, ambient cold temperatures and decompression stress, changes in lung function were small and suggest a low likelihood of clinical significance. Recent evidence points to no accelerated loss of lung function in military or recreational scuba divers over time. Thus,
the impact of diving on pulmonary function largely depends on factors associated with the individual diving exposure. However, in susceptible subjects clinically relevant worsening of lung function may occur even after single shallow-water scuba dives.
Eur Respir Rev. 2017 Mar 29;26(143). pii: 160097. doi:10.1183/16000617.0097-2016.
