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目的 探讨热带海区海难落水人员的发病情况及其致病机制。方法 对 2 0 0 1年第 10号热带风暴“天兔”引起的海难落水部分幸存者 2 2例的落海及漂浮情况、主要症状、体征、辅助检查结果和诊断进行回顾性研究。结果 本组 2 2例落水后海水浸泡时间 (2 6 .9± 5 .3) h,轻微外伤发生率 10 0 %(2 2 / 2 2 ) ,被海洋生物袭击发生率 2 2 .7% (5 / 2 2 )。主要病变为体力衰竭 2 2 / 2 2例 (10 0 % ) ,睡眠剥夺 2 2 /2 2例 (10 0 % ) ,中～重度脱水 2 2 / 2 2例 (10 0 % ) ,血液浓缩 2 2 / 2 2例 (10 0 % ) ,休克 1/ 2 2例 (4.5 % ) ,皮肤伤口感染 2 2 / 2 2例 (10 0 % ) ,骨折 1/ 2 2例 (4.5 % ) ,代谢性酸中毒 19/ 19例 (10 0 % ) ,氮质血症 19/ 19例(10 0 % ) ,应激性溃疡 12 / 18例 (6 6 .7% )。结论 热带海区海难落水人员在海上漂浮期间的主要致病原因为缺食缺水、睡眠剥夺、过度体力消耗、长期海水浸泡和应激 ,其他致病原因尚有感染、机械损伤和海洋生物损伤等。
Objective To investigate the incidence of pathogens and their pathogenesis in tropical sea areas. Methods A retrospective study was performed on the falling and floating conditions, main symptoms, signs, auxiliary examination results and diagnosis of 22 survivors of the marine storm-caused waterfall caused by Tropical Storm “Tian-hao” in 2001. Results After the water immersed in the seawater, the time of seawater immersion was (26.9 ± 5.3) h, the incidence of mild trauma was 100% (2 2/2 2), the incidence of sea creature attack was 22.7% 5/2 2). The main pathological changes were 22/2 (100%) of physical failure, 22/2 (100%) sleep deprivation, moderate / severe dehydration 2 2/2 (10 0%), blood concentration 2 2 of 22 cases (100%), 1/2 of 2 cases (4.5%) of shock, 22/2 cases of skin wound infection (100%), 1/2 of 2 cases (4.5% 19/19 cases (100%) of acidosis, 19/19 cases (100%) of azotemia and 12/18 (6.6%) of stress ulcer. Conclusion The main causative agents during the sea floating in tropical sea areas are lack of food and water, sleep deprivation, excessive physical exertion, long-term seawater immersion and stress. Other causes of infection include infection, mechanical damage and marine organism damage .