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一名现役飞行员在高空舱训练后减压病的潜伏表现

Latent Presentation of Decompression Sickness After Altitude Chamber Training in an Active Duty Flier.

作者信息

Gentry James, Rango Juan, Zhang Jianzhong, Biedermann Shane

机构信息

Tinker AFB, Oklahoma City, OK, USA.

出版信息

Aerosp Med Hum Perform. 2017 Apr 1;88(4):427-430. doi: 10.3357/AMHP.4691.2017.

Abstract

BACKGROUND

Decompression sickness (DCS) is a potential danger and risk for both divers and aircrew alike. DCS is also a potential side effect of altitude (hypobaric) chamber training as well and can present long after training occurs. Literature review shows that altitude chamber induced DCS has approximately a 0.25% incidence.

CASE REPORT

A 32-yr-old, active duty military member developed symptoms of DCS 3 h after his hypobaric chamber training. Unfortunately, he did not seek treatment for DCS until 48 h after the exposure. His initial treatment included ground level oxygen therapy for 30 min at 12 L of oxygen per minute using a nonrebreathing mask. He achieved complete symptom resolution and was returned to duty. However, 12 d after his initial Flight Medicine evaluation, the patient returned complaining of a right temporal headache, multijoint pains, and fatigue. He was treated in the hyperbaric chamber and had complete resolution of symptoms. He was returned to flying status and 5 mo later denied any return of symptoms.

DISCUSSION

Hypobaric chamber familiarity training is a requirement for all military aircrew personnel to allow them assess their ability to identify symptoms of hypoxia. This training method is not only costly to maintain, but it also places aircrew and chamber technicians at risk for potential long-term side effects from failed recompression treatment of DCS. We are presenting a case of recurrent DCS symptoms 12 d after initial ground level oxygen therapy.Gentry J, Rango J, Zhang J, Biedermann S. Latent presentation of decompression sickness after altitude chamber training in an active duty flier. Aerosp Med Hum Perform. 2017; 88(4):427-430.

摘要

背景

减压病(DCS)对潜水员和机组人员来说都是一种潜在的危险和风险。减压病也是高空(低压)舱训练的一种潜在副作用,并且可能在训练结束很长时间后才出现。文献综述表明,高空舱诱发的减压病发病率约为0.25%。

病例报告

一名32岁的现役军人在其低压舱训练3小时后出现了减压病症状。不幸的是,直到暴露后48小时他才寻求减压病治疗。他的初始治疗包括使用非重复呼吸面罩,以每分钟12升氧气的流量进行30分钟的地面吸氧治疗。他的症状完全缓解并重返岗位。然而,在他首次飞行医学评估后的12天,该患者回来抱怨右颞部头痛、多关节疼痛和疲劳。他在高压舱接受了治疗,症状完全缓解。他恢复了飞行状态,5个月后未出现任何症状复发。

讨论

低压舱熟悉训练是所有军事机组人员的一项要求,以便他们评估自己识别缺氧症状的能力。这种训练方法不仅维护成本高昂,而且还使机组人员和舱室技术人员面临因减压病再压缩治疗失败而产生潜在长期副作用的风险。我们报告了一例在初始地面吸氧治疗12天后出现复发性减压病症状的病例。

金特里J、兰戈J、张J、比德曼S。一名现役飞行员在高空舱训练后减压病的潜伏表现。航空航天医学与人类表现。2017;88(4):427 - 430。

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