Mehta S R, Srinivasan K V, Bindra M S, Kumar M R, Lahiri A K
Deputy Director Medical Services, 92 Base Hospital, C/o 56 APO, India.
J Assoc Physicians India. 2000 Jul;48(7):674-6.
Drowning and near drowning is a common cause of accidental death all over the world; specially in road traffic accidents over bridges, swimming pool and boat tragedies. Cold water drowning resulting in hypothermia can lead to instant death before actual drowning. Five cases of near drowning (ND) in cold water, who presented with varied clinical picture like coma with decerebrate rigidity and fixed dilated pupils, hypertension with coma and delayed pulmonary oedema (Secondary drowning) are reported. Energetic management with continuous positive airway pressure was very rewarding in all patients with ND except in one who had transient organic psychosis persisting for two weeks followed by minimal cognitive defect in the form of slow mentation, lack of drive and mild irritability (Bender Gestald Test Score of 53). We have tried to analyse some of the clinical features of ND and the sequel associated with it. The management as well as recent developments in the field are also discussed.
溺水和近乎溺水是全球意外死亡的常见原因；特别是在桥梁交通事故、游泳池事故和船只悲剧中。冷水溺水导致体温过低，可在实际溺水前导致即刻死亡。本文报告了5例冷水近乎溺水（ND）病例，这些病例呈现出不同的临床表现，如去脑强直昏迷和瞳孔固定散大、高血压伴昏迷以及延迟性肺水肿（继发性溺水）。除1例患者出现持续两周的短暂性器质性精神病，随后出现以思维迟缓、缺乏动力和轻度易怒为表现的轻度认知缺陷（本德尔视觉运动格式塔测验评分为53分）外，对所有ND患者采用持续气道正压通气进行积极治疗均取得了很好的效果。我们试图分析ND的一些临床特征及其相关后遗症。同时还讨论了该领域的治疗方法以及最新进展。
