Pearn J H, De Buse P, Mohay H, Golden M
Med J Aust. 1979 May 19;1(10):463-4. doi: 10.5694/j.1326-5377.1979.tb127044.x.
Sequential neurological and intellectual recovery after childhood near-drowning is discussed. Decisions concerning the persistence and intensity of resuscitation require a knowledge of the natural history of intellectual improvement after rescue from near-drowning. A severe case of fresh-water immersion, leading to recovery, is described. Evidence is presented to suggest that the time interval of one hour before the first spontaneous respiratory gasp forms the upper limit of the apnoeic time bracket after which survival can still be expected, and to indicate that intellectual improvement (to a measured IQ of 97) can occur even after initial decerebrate signs if vigorous therapy is prosecuted. The proportion of cases capable of sequential neurological improvement is unknown. A time base for sequential clinical and intellectual improvement after near-drowning is presented to form a yardstick with which future cases may be compared.
本文讨论了儿童溺水后神经系统和智力的相继恢复情况。关于复苏的持续时间和强度的决策需要了解从溺水状态获救后智力改善的自然病程。本文描述了一例因淡水浸没导致严重溺水但最终康复的病例。有证据表明，首次自主呼吸喘息前一小时的时间间隔构成了呼吸暂停时间范围的上限，在此之后仍有望存活；并且表明，即使最初出现去大脑强直体征，如果积极进行治疗，智力仍可得到改善（测得智商达97）。能够实现神经系统相继改善的病例比例尚不清楚。本文给出了溺水后临床和智力相继改善的时间基准，以形成一个可用于比较未来病例的标准。
