Tetzlaff K, Neubauer B, Reuter M, Warninghoff V
Department of Diving and Hyperbaric Medicine, Naval Medical Institute, Kiel, Germany.
Aviat Space Environ Med. 1996 Dec;67(12):1198-200.
A 22-yr-old healthy male diver performed a dive using a closed circuit oxygen rebreathing apparatus according to normal procedure. After the dive he developed clinical symptoms of mediastinal emphysema. A chest X-ray taken 1 d after the dive showed a discrete "tram track" sign in the left paracardial region. Spiral volumetric computed tomography of the chest 4 d postinjury detected a small subpleural emphysematous bulla next to the left ventricle, the pneumomediastinum being absorbed in the meantime. Clinical outcome of pulmonary decompression barotrauma in the case of oxygen rebreathing may be different from that in compressed air diving, due to the altered gas physics. The necessity for computed tomography of the chest is emphasized, preferably using the spiral mode, in any case of suspected pulmonary barotrauma.
一名22岁的健康男性潜水员按照常规程序使用闭路式氧气再循环呼吸器进行了潜水。潜水后，他出现了纵隔气肿的临床症状。潜水后1天拍摄的胸部X光片显示在心旁左侧区域有离散的“轨道征”。受伤后4天进行的胸部螺旋容积计算机断层扫描检测到左心室旁有一个小的胸膜下气肿性大疱，同时纵隔气肿正在吸收。由于气体物理学的改变，在氧气再循环情况下肺减压性气压伤的临床结果可能与压缩空气潜水不同。对于任何疑似肺气压伤的病例，强调有必要进行胸部计算机断层扫描，最好采用螺旋模式。
