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潜水时截瘫(13例)

Paraplegia during skin-diving. (13 cases).

作者信息

Girard R

出版信息

Paraplegia. 1980 Apr;18(2):123-6. doi: 10.1038/sc.1980.20.

Abstract

Thirteen paraplegias after decompression have been treated in the 5 centres of Lyons, Geneva, Mulhouse, Basel and Strasbourg. All these cases are somehow comparable: 12 males, 1 female, skilled and well-trained divers are involved from 27 to 50 years. Submersion between 30 and 42 metres, during 15 to 30 minutes. Ascension with or without decompression stops. Beginning with sudden posterior thoracic, 4 feeling sick, 2 becoming briedly unconscious, paralysis after a while (until 1 hour). All have received hyperbaric oxygenation (from 1 to 5 hours later), with an improvement for 10. Neurological findings. 5 tetraplegics, 7 para-(5 with Brown-Sequard), and one LI. Quickly, the tetraplegics improved to a thoracic level. In two cases, paraplegia remained complete at thoracic level. The others had a better evolution; the paralysis improved slowly, with marked spasticity, impaired sensation did not improve to such an extent, often localised at a lower level, with sexual impotence. Micturitions became normal but with often urine leakages. This rather favourable evolution allowed 11 to go back to work.

摘要

里昂、日内瓦、米卢斯、巴塞尔和斯特拉斯堡的5个中心共治疗了13例减压术后截瘫患者。所有这些病例在某种程度上具有可比性:12名男性,1名女性,均为27至50岁经验丰富且训练有素的潜水员。潜水深度在30至42米之间,时长15至30分钟。上升时有无减压停留。起病时突然出现胸背部不适,4人感到恶心,2人短暂失去意识,一段时间后(最长1小时)出现瘫痪。所有人均接受了高压氧治疗(1至5小时后),其中10人病情有所改善。神经学检查结果:5例四肢瘫,7例截瘫(5例为布朗 - 色夸综合征),1例腰髓损伤。很快,四肢瘫患者的病情改善至胸髓水平。2例患者截瘫仍为胸髓水平完全性瘫痪。其他患者病情进展较好;瘫痪症状缓慢改善,伴有明显痉挛,感觉障碍改善程度不大,常局限于较低水平,伴有性功能障碍。排尿恢复正常,但常伴有尿失禁。这种相对较好的病情进展使11人能够重返工作岗位。

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