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病例报告:重新评估脊柱减压病后安全恢复潜水的指南:来自一个具有挑战性病例的见解

Case report: Reassessing guidelines for safe resumption of diving after spinal decompression sickness: insights from a challenging case.

作者信息

Druelle Arnaud, Blatteau Jean-Eric, Daubresse Duchadeuil Lucile, Morin Jean, Roffi Romain, Dufresne Pierre-Louis, Lehot Henri, Castagna Olivier

机构信息

Ste Anne Military Hospital (HIA Ste Anne), Service de médecine hyperbare et d'expertise plongée (SMHEP), Toulon, France.

LAMHESS (UPR 6312), Université de Nice, Nice, France.

出版信息

Front Med (Lausanne). 2024 May 9;11:1347465. doi: 10.3389/fmed.2024.1347465. eCollection 2024.

Abstract

BACKGROUND

Recreational divers who have experienced Spinal Decompression Sickness (DCS) often aspire to return to their diving activities. Traditionally, it is recommended to observe a waiting period of several months before contemplating a return to unrestricted diving, particularly when clinical symptoms are absent, spinal cord Magnetic Resonance Imaging shows no anomalies, and the evaluation for Patent Foramen Ovale (PFO) returns negative results.

METHODS

This article presents a compelling case study involving a 51-year-old recreational scuba diver who encountered two episodes of spinal decompression illness within a two-year timeframe. Notably, the search for a PFO produced negative results. The primary objective of this article is to underscore the critical importance of a meticulously planned approach to resuming diving after DCS incidents, emphasizing the potential for recurrence and the essential preventive measures.

CONCLUSION

We delve into the intricate decision-making process for returning to diving, emphasizing the significance of clinical evaluations, PFO assessments, spinal cord Magnetic Resonance Imaging, and the absence of clinical symptoms. By recognizing the risk of recurrence and the need for proactive prevention measures, we provide recommendations for both medical professionals and divers, with the ultimate goal of enhancing safety and informed decision-making within the diving community.

摘要

背景

经历过脊髓减压病(DCS)的休闲潜水者常常渴望恢复潜水活动。传统上,建议在考虑恢复无限制潜水之前观察数月的等待期,尤其是在没有临床症状、脊髓磁共振成像显示无异常且卵圆孔未闭(PFO)评估结果为阴性时。

方法

本文介绍了一个引人注目的案例研究,涉及一名51岁的休闲水肺潜水者,他在两年时间内遭遇了两次脊髓减压病发作。值得注意的是,对PFO的检查结果为阴性。本文的主要目的是强调在减压病事件后恢复潜水时精心规划方法的至关重要性,强调复发的可能性以及必要的预防措施。

结论

我们深入探讨恢复潜水的复杂决策过程,强调临床评估、PFO评估、脊髓磁共振成像以及无临床症状的重要性。通过认识到复发风险和积极预防措施的必要性,我们为医学专业人员和潜水者提供建议,最终目标是提高潜水群体的安全性和明智决策能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d180/11111850/9768dac79cd1/fmed-11-1347465-g001.jpg

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