新型氦氧潜水减压表安全性实验验证_周英杰.pdf

海军军医大学学报2023 年 4 月第 44 卷第 4 期http:/Academic Journal of Naval Medical University,Apr.2023,Vol.44,No.4 427 论 著 收稿日期 2022-07-02 接受日期 2022-11-28基金项目 军队后勤科研重点项目（BHJ19J007）Supported by Key Program of Logistics Research of PLA(BHJ19J007).作者简介 周英杰，硕士生 E-mail:yingjie_；庆 龙，博士，主治医师 E-mail:共同第一作者（Co-first authors）*通信作者（Corresponding author）.Tel:021-81871141,E-mail:wg_新型氦氧潜水减压表安全性实验验证周英杰1，庆 龙2，朱包良1，衣洪杰3，王晔炜4，张 坤1，徐伟刚1*1.海军军医大学（第二军医大学）海军特色医学中心潜水与高气压医学研究室，上海 2004332.海军军医大学（第二军医大学）海军特色医学中心海潜科，上海 2000523.海军军医大学（第二军医大学）第一附属医院高压氧治疗科，上海 2004334.海军军医大学（第二军医大学）海军特色医学中心援潜救生医学与装备技术训练队，上海 200433摘要 目的 以猪模型验证新型氦氧潜水减压表的安全性，初步探索用动物实验结果评估潜水减压方案安全性的方法。方法 在专门建造的大动物加压舱内进行模拟潜水，按系统分层抽样法对常规作业深度每隔 6 m、训练深度和例外暴露深度每隔 9 m从新型氦氧潜水减压表中选取潜水方案进行验证，每个方案验证 46 次，观察模拟潜水期间动物的表现及减压后减压病症状、流经心脏的气泡，通过检测血液相关指标评估内皮损伤、炎症反应和氧化应激水平。结果 在全部 14 个验证方案中，所有动物均无氧中毒和减压病症状，出舱后未见循环气泡。在模拟潜水前和减压后即刻、6 h、24 h各时间点，动物的炎症反应指标（IL-1、TNF-）、内皮损伤指标（细胞间黏附分子 1、血管细胞黏附分子 1）和氧化应激指标（H2O2）差异均无统计学意义（P均0.05）。结论 就猪潜水模型而言，新型氦氧潜水减压表具有优良的安全性。本研究初步建立的实验评估潜水减压方案安全性的方法还需要更多的数据验证。关键词 氦氧潜水；减压病；减压方案；动物模型；减压表中图分类号 R 841.1文献标志码 A文章编号 2097-1338(2023)04-0427-06Experimental verification on the safety of a newly-developed helium-oxygen diving decompression tableZHOU Ying-jie1,QING Long2,ZHU Bao-liang1,YI Hong-jie3,WANG Ye-wei4,ZHANG Kun1,XU Wei-gang1*1.Department of Diving and Hyperbaric Medical Research,Naval Medical Center,Naval Medical University(Second Military Medical University),Shanghai 200433,China2.Department of Naval Diving Medicine,Naval Medical Center,Naval Medical University(Second Military Medical University),Shanghai 200052,China3.Department of Hyperbaric Oxygen,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China4.Department of Submarine Rescue Training,Naval Medical Center,Naval Medical University(Second Military Medical University),Shanghai 200433,China Abstract Objective To verify the safety of a newly-developed helium-oxygen diving decompression table in a swine model and preliminarily explore a method for evaluating the safety of decompression profiles based on animal experimental results.Methods Simulated diving was performed in a purpose-built pressurized chamber for large animals.The diving profiles were verified every 6 m at regular operation depth and every 9 m at training and exceptional exposure depth by systematic stratified sampling according to the newly-developed helium-oxygen diving decompression table,and each profile was verified 4-6 times.The animal conditions during simulated diving and symptoms of decompression sickness(DCS)and bubbles flowing through the heart after depression were observed.Blood indicators related to endothelial injury,inflammatory response and oxidative stress levels were assessed.Results No symptoms of oxygen toxicity or DCS,or circulating bubbles were found in the animals exposed with all the 14 tested profiles.The inflammatory response indexes(interleukin 1,tumor necrosis factor),endothelial injury indexes(intercellular adhesion molecule 1,vascular cell adhesion molecule 1)and oxidative stress index(H2O2)were compared before simulated diving and immediately(0 h),6 h and 24 h after decompression,and there were no significant differences(all P0.05).Conclusion As far as the swine model is concerned,the newly-developed helium-oxygen diving decompression table has excellent safety.More data are needed to DOI：10.16781/j.CN31-2187/R.20220560海军军医大学学报 2023 年 4 月，第 44 卷 428 我国海洋发展战略的持续拓展要求相关的科技创新伴随跟进。潜水作为一项水下探索的通用技术，已被广泛应用于军事、商业、公共安全、科学考察和休闲运动等多个领域。5060 m以浅的潜水通常采用压缩空气作为呼吸气，更深的潜水需要采用氦氧混合气才能避免氮麻醉、降低呼吸阻力1。我国早期使用的氦氧潜水减压表原型引进自苏联，虽几经优化，但存在固有欠缺，难以满足现代深潜水作业需求2。在海上紧急打捞任务的驱动下，本课题组历时 10 年开发了新型氦氧潜水减压技术，形成了减压表，并已进行了理论安全性评估3，本研究旨在通过动物实验验证其安全性。1 材料和方法1.1 实验动物及准备 68 个月龄去势后的雄性巴马猪（n60），体重 2025 kg，购于上海甲干生物科技有限公司实验动物生产许可证号：SCXK（沪）2020-0006。在海军军医大学（第二军医大学）实验动物中心适应性饲养 1 周后转移至实验室。每日按体重的 3%给予普通饲料，自由饮水。颈内静脉置管 3 d 后按预定的潜水方案进行模拟潜水实验。1.2 验证方案的选择 从新型氦氧潜水减压表中按照系统分层抽样原则，对常规作业深度（60 120 m）每隔 6 m抽取 1 个方案，对训练深度（60 m 以浅）和例外暴露深度（120 m 以深）每隔 9 m 抽取 1 个方案。水下作业时间随深度递进交替选择适宜时间极限、适宜中位时间和例外暴露极限时间。最终抽取 14 个方案进行验证（表 1），每个方案验证 46 次。1.3 模拟潜水 将巴马猪置于大动物加压舱内，根据方案要求，采用特定浓度氦氧混合气完成加压、稳压和减压。减压过程中，根据不同深度呼吸气体要求先后呼吸氦氧混合气、高纯空气和氧气。持续监控舱内二氧化碳浓度、温度和相对湿度4，并分别维持其水平为0.03%、2832 和 50%80%。verify the preliminary experimental method for evaluating the safety of diving decompression table.Key words helium-oxygen diving;decompression sickness;decompression profiles;animal models;decompression tableAcad J Naval Med Univ,2023,44(4):427-432表 1 选取的氦氧潜水减压验证方案Tab 1 Selected helium-oxygen diving decompression verification profilesDepth/mBottom time/minOxygen concentration/%Up to the first stopTime of each stop in different depths/minaTotal decompression time/min90m 85m 80m 75m 70m 65m 60m 55m 50m 45m 40m 35m 30m 27m 24m 21m 18m 15m 12m 9m6m 39 3030.0-32.024025121235 69 48 6025.5-27.53002358152860124 5710021.5-23.525035812121518243665201 63 3020.0-21.5410223355182060123 69 6018.5-20.03402351010121215273665201 7510016.5-18.03103358121515202225273665260 81 3015.5-17.043022233588