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內科學誌 Scopus

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篇名 Concurrent Pneumocephalus, Pneumothorax and Pneumomediastinum in A Submarine Sailor
卷期 28:2
並列篇名 高壓艙訓練引發氣腦症併發氣胸及縱膈腔氣腫
作者 楊宗翰
頁次 086-090
關鍵字 SeizurePneumocephalusDysbarismScopusTSCI
出刊日期 201704
DOI 10.6314/JIMT.2017.28(2).04

中文摘要

減壓症,俗稱潛水夫病,指的是當進行水下或任何有壓力變化的活動時,如果沒有經過適當的減壓程序,就容易導致氣體從血液中或肺泡跑到身體其他部位,進而引起關節疼痛,頭痛,視力模糊,呼吸喘,意識喪失或抽搐等症狀,嚴重的甚至會導致死亡。這篇病例報告是有關一位男性因預期將至潛艦服役,所以接受例行性的潛水壓力艙訓練,但訓練途中發生突發性的意識喪失併抽慉現象,而當病患清醒後就出現四肢無力,感覺異常及胸痛等症狀,經檢查後確認其罹患減壓症,包括了氣腦,氣胸及中縱膈腔氣腫。在一連續的治療過程,其中包括大量水分補充,高濃度氧氣及胸管引流治療後,病情迅速獲得明顯改善,但仍存有局部肢體感覺異常的後遺症。

英文摘要

Dysbarism, also known as diver’s disease, the bends or caisson disease, is usually caused by underwater activities. It bothers the divers, no matter whether they underwent scuba or just free diving, with the most frequent symptoms including joint pain, headache, visual disturbance and shortness of breath. The most dreadful, but rare, symptom is seizure with change of consciousness that could lead to submersion injuries and even death. In some circumstances, it might also happen when people underwent diving training and medical hyperbaric oxygen therapy in the recompression chamber. Herein, we present one patient who planned to work on a submarine and received hyperbaric training in the recompression chamber. Just when descent similar to pressure at 110 feet deep under sea level, sudden onset of dizziness and then loss of consciousness with generalized seizure happened. After a return of consciousness in a few minutes, the patient showed four-limb paralysis with sensory impairment and chest pain. The computed tomography of the brain and chest performed in the emergency department concluded with a diagnosis of concurrent penumocephalus, pneumothorax and pneumomediastinum. After treatment with fluid hydration, oxygen therapy and chest thoracostomy drainage, conditions above improved, but the sensory impairment remained. Recompression therapy was not performed due to rapid clinical regression of neurologic symptoms and the multiple pulmonary cysts that may lead to further barotrauma.

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