一项比较两种治疗方案用于轻度减压病初始治疗的前瞻性单盲随机临床试验。

A prospective single-blind randomised clinical trial comparing two treatment tables for the initial management of mild decompression sickness.

机构信息

Department of Hyperbaric Medicine, Fiona Stanley Hospital, Murdoch WA, Australia.

Corresponding author: Dr Neil Banham, Department of Hyperbaric Medicine, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch WA 6150, Australia,

出版信息

Diving Hyperb Med. 2022 Jun 30;52(2):85-91. doi: 10.28920/dhm52.2.85-91.

DOI:10.28920/dhm52.2.85-91

PMID:35732279

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9522606/

Abstract

INTRODUCTION

Limited evidence suggests that shorter recompression schedules may be as efficacious as the US Navy Treatment Table 6 (USN TT6) for treatment of milder presentations of decompression sickness (DCS). This study aimed to determine if divers with mild DCS could be effectively treated with a shorter chamber treatment table.

METHODS

All patients presenting to the Fremantle Hospital Hyperbaric Medicine Unit with suspected DCS were assessed for inclusion. Participants with mild DCS were randomly allocated to receive recompression in a monoplace chamber via either a modified USN TT6 (TT6m) or a shorter, custom treatment table (FH01). The primary outcome was the number of treatments required until resolution or no further improvement (plateau).

RESULTS

Forty-one DCS cases were included, 21 TT6m and 20 FH01. Two patients allocated to FH01 were moved to TT6m mid-treatment due to failure to significantly improve (as per protocol), and two TT6m required extensions. The median total number of treatments till symptom resolution was 1 (IQR 1-1) for FH01 and 2 (IQR 1-2) for TT6m (P = 0.01). More patients in the FH01 arm (17/20, 85%) showed complete symptom resolution after the initial treatment, versus 8/21 (38%) for TT6m (P = 0.003). Both FH01 and TT6m had similar overall outcomes, with 19/20 and 20/21 respectively asymptomatic at the completion of their final treatment (P = 0.97). In all cases where two-week follow-up contact was made, (n = 14 FH01 and n = 12 TT6m), patients reported maintaining full symptom resolution.

CONCLUSIONS

The median total number of treatments till symptom resolution was meaningfully fewer with FH01 and the shorter treatment more frequently resulted in complete symptom resolution after the initial treatment. There were similar patient outcomes at treatment completion, and at follow-up. We conclude that FH01 appears superior to TT6m for the treatment of mild decompression sickness.

摘要

简介

有限的证据表明，较短的复压时间表可能与美国海军治疗表 6（USN TT6）一样有效，用于治疗减压病（DCS）的较轻表现。本研究旨在确定轻度 DCS 潜水员是否可以通过较短的舱室治疗表有效治疗。

方法

所有因疑似 DCS 而到弗里曼特尔医院高压医学科就诊的患者均进行了评估。将患有轻度 DCS 的患者随机分配接受单室治疗，使用改良的美国海军 TT6（TT6m）或较短的定制治疗表（FH01）进行复压。主要结局是达到缓解或无进一步改善（平台期）所需的治疗次数。

结果

共纳入 41 例 DCS 病例，21 例 TT6m 和 20 例 FH01。由于未按方案显著改善（FH01 组有 2 例），2 例 FH01 患者在治疗中途转用 TT6m，2 例 TT6m 需要延长治疗。FH01 组达到症状缓解的中位总治疗次数为 1（IQR 1-1），TT6m 组为 2（IQR 1-2）（P = 0.01）。FH01 组（17/20，85%）在首次治疗后有更多的患者完全缓解症状，而 TT6m 组（8/21，38%）则较少（P = 0.003）。FH01 和 TT6m 的总体结局相似，分别有 19/20 和 20/21 名患者在完成最后一次治疗时无症状（P = 0.97）。在所有完成两周随访的患者中（FH01 组 n = 14，TT6m 组 n = 12），患者报告保持完全缓解症状。