Henckes A, Arvieux J, Cochard G, Jézéquel P, Arvieux C C
Center for Hyperbaric Medicine, CHU Brest, Pôle Anesthesiology Intensive Care, Department of Anesthesiology Intensive Care, Brest, F-29200 France.
Undersea Hyperb Med. 2011 May-Jun;38(3):213-6.
We report the case of a healthy 21-year-old woman who performed iterative breath-hold dives in relatively cold water, not exceeding depths of 5 meters but with "empty lungs." At the end of a dive, after experiencing an intense involuntary diaphragmatic contraction underwater, she presented hemoptysis followed by chest pain and cough. Chest radiography and computed tomography were performed 24 hours later, confirming the diagnosis of pneumomediastinum. The clinical course was benign: However, chest pain and effort dyspnea lasted for a few weeks. The pathophysiology of this accident may be explained by a combination of mechanisms involved in several clinical entities, namely pulmonary edema of immersion, pulmonary barotrauma and spontaneous pneumomediastinum.
我们报告了一名21岁健康女性的病例，她在相对较冷的水中进行反复屏气潜水，深度不超过5米，但肺部“排空”。在一次潜水结束时，她在水下经历了强烈的非自主性膈肌收缩，随后出现咯血，接着是胸痛和咳嗽。24小时后进行了胸部X光检查和计算机断层扫描，确诊为纵隔气肿。临床病程为良性：然而，胸痛和劳力性呼吸困难持续了几周。这起事故的病理生理学可能是由几种临床病症所涉及的多种机制共同作用导致的，即浸没性肺水肿、肺气压伤和自发性纵隔气肿。
