Goldenberg I, Shupak A, Shoshani O
Israel Naval Medical Institute, Haifa.
Aviat Space Environ Med. 1996 Jan;67(1):57-60.
A 49-yr-old male presented with paraparesis and urinary incontinence that appeared 10 min after surfacing from a dive. Treatment was started on an extended USN table 6, but the symptoms persisted. Twenty-four hours later, he was treated with oxy-helium table CX-30, resulting in marked improvement in gait and in sensory and motor function. Urodynamic examination indicated an upper motor neuron lesion; bilateral decreased amplitude of the somatosensory evoked potential was found on stimulation of the tibial nerves; no response below the upper limbs was elicited on central motor conduction time (CMCT) testing; MRI showed lesions in the lower dorsal cord. The patient's condition was further improved by an additional 10 hyperbaric oxygenation sessions, with complete restoration of urinary control and virtually complete sensory and motor recovery. Follow-up urodynamic studies were normal. CMCT recordings showed a bilateral lower limb small-amplitude response. The present case reinforces the limited clinical data regarding the value of oxy-helium in the treatment of neurological decompression sickness, even when primary treatment with oxygen tables is unsuccessful.
一名49岁男性在潜水浮出水面10分钟后出现双下肢轻瘫和尿失禁。开始在延长的美国海军6号治疗方案下进行治疗，但症状持续存在。24小时后，对其采用氦氧CX - 30治疗方案，结果步态以及感觉和运动功能有显著改善。尿动力学检查显示为上运动神经元损伤；刺激胫神经时，双侧体感诱发电位波幅降低；在中枢运动传导时间（CMCT）测试中，上肢以下未引出反应；MRI显示下胸段脊髓有病变。通过额外10次高压氧治疗，患者病情进一步改善，排尿控制完全恢复，感觉和运动功能几乎完全恢复。随访尿动力学研究结果正常。CMCT记录显示双侧下肢有小幅度反应。本病例强化了关于氦氧在治疗神经型减压病方面价值的有限临床数据，即使在最初使用氧气治疗方案未成功的情况下也是如此。
