潛水活動之健康危害及其處置與預防

Health Hazard of Diving Activities and It's Therapeutic Management and Prevention

10.30027/CJOM.201010.0005

劉月琪(Yueh-Chi Liu)；劉永芳(Yung-Fang Liou)

減壓症 ； 動脈氣體栓塞 ； 職業潛水 ； decompression sickness ； arterial gas embolism ； diving activities

中華職業醫學雜誌

17卷4期（2010 / 10 / 25）

267 - 277

繁體中文

台灣四面環海，海洋資源豐富，隨著科技的進步，加速海洋經濟開發的同時，潛水從業人員的需求量亦相對地提升。統計資料顯示台灣地區職業潛水人員之意外事故發生率遠高於其他國家，因此從事潛水活動人員之健康議題值得重視。從事潛水活動除可能產生急性潛水意外傷害，亦可能出現慢性組織異常病變。急性潛水意外傷害包括擠壓傷害、氮迷醉及高壓神經症狀、氣體中毒、缺氧症、減壓症、動脈氣體栓塞等；慢性組織異常病變則好發於長骨骨骼系統、呼吸系統疾精神神經系統。潛水活動所發生的傷害以減壓症和動脈氣體栓塞二種最為嚴重，且為潛水意外事故死亡的主要原因，治療方面可遵循”Four R's”原則，並藉由病人姿勢擺位、體液補充、體溫控制及藥物治療輔助療效。此外，瞭解罹病之高風險行業、危險因子、潛水注意事項，有助於達到預防潛水活動產生之健康危害。

Taiwan, surrounded by the sea, rich in marine resources. With the advances in technology, accelerate the development of marine economy, while the demand for diving professionals are relatively to upgrade. Statistics showed that the accident rate of professional divers in Taiwan is much higher than other countries. Therefore, the health issues of personnel involved in diving activities are worth of attention. In addition to diving accident may have acute injuries, chronic tissue abnormalities may occur in persons engaging in diving activities. Acute injuries of diving accident included barotraumas, nitrogen narcosis, high pressure nervous syndrome, gas toxicity, hypoxia, decompression sickness, arterial gas embolism, etc. Chronic tissue abnormalities may develop in long bone skeletal system respiratory system, and psychoneural system. Decompression sickness and arterial gas embolism were the most serious injuries and the major causes of death in diving accident. The therapeutic management was guided by the principle of Four R's , with auxiliary efficacy contributed by positioning, fluid supplement, temperature control and medication treatment. Furthermore, understanding high-risk industries, risk factors and diving precautions contributed to achieving prevention of health hazard from diving activities.