Diederich Taylor, Briggs Allyson M, Malik Adrienne, Beaver Bryan
Department of Emergency Medicine University of Kansas Medical Center, University of Kansas Health System Kansas City Kansas USA.
J Am Coll Emerg Physicians Open. 2024 Mar 18;5(2):e13144. doi: 10.1002/emp2.13144. eCollection 2024 Apr.
Decompression sickness describes the clinical pathology that ensues when rapid decompression from a highly pressurized environment causes the formation of venous and extravascular inert gas bubbles. Symptoms vary widely, commonly including arthralgias, myalgias, paresthesias, and numbness. Severe and potentially life-threatening pathology, such as neurologic impairment, cardiopulmonary instability, and gastrointestinal hemorrhage, can occur as well. Most think of diving endeavors as a common exposure predisposing to this condition, commonly referred to as "the bends." Other occupational exposures documented in the medical literature include military training, caisson work, such as in mining and bridge construction, and hyperbaric treatment attendance. This article presents the case of a 32-year-old male presenting with a mottled rash, arthralgias, myalgias, headache, vision changes, and weakness, which is found to have decompression sickness secondary to occupational exposure in a factory-based pressurized chamber. The patient underwent two hyperbaric chamber sessions with complete resolution of his symptoms. During hospitalization, he was found to have a patent foramen ovale. The patient was counseled to avoid further occupational exposure.
减压病描述的是当从高压环境快速减压导致静脉和血管外惰性气泡形成时所产生的临床病理情况。症状差异很大,常见的包括关节痛、肌痛、感觉异常和麻木。严重且可能危及生命的病理情况,如神经功能损害、心肺功能不稳定和胃肠道出血,也可能发生。大多数人认为潜水活动是导致这种情况的常见诱因,通常称为“减压病”。医学文献中记录的其他职业暴露包括军事训练、沉箱作业,如采矿和桥梁建设中的沉箱作业,以及高压治疗参与。本文介绍了一名32岁男性的病例,该患者出现了斑驳皮疹、关节痛、肌痛、头痛、视力变化和虚弱症状,经诊断为因在工厂的加压舱中职业暴露继发的减压病。该患者接受了两次高压舱治疗,症状完全缓解。住院期间,发现他有卵圆孔未闭。建议该患者避免进一步的职业暴露。