饱和潜水期间椎间盘突出的处理:1例报告。

Undersea biomedical research Pub Date : 1992-05-01
D M Stevens, B G Caras, E T Flynn, A J Dutka, J W Thorp, E D Thalmann
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引用次数: 0

摘要

在5.0和5.5腹肌饱和潜水的研究中,2名潜水员发生了L5-S1椎间盘髓核急性突出。在这两种情况下,疼痛严重到需要静脉注射吗啡或肌肉注射哌替啶。尽管这些潜水员出现的症状经常被认为是需要立即进行手术咨询的指征,但我们认为紧急减压带来了不可接受的风险,减压病(DCS)会在急性炎症区域发展。在这两个病例中,都进行了严格的卧床治疗和药物治疗。在第一种情况下,在开始标准的美国海军饱和减压计划之前,在深度上花费了12小时,将舱内的氧气分压升高到0.50大气压。在第二种情况下,遵循保守的He-N2-O2混合减压计划到水面。在这两种情况下,没有进行初始向上偏移。从5.5 atm腹肌开始所需的减压时间为57 h 24 min,从5.0 atm腹肌开始所需的减压时间为55 h 38 min。在减压过程中,第一潜水员的神经系统检查有所改善,他需要的静脉麻醉药量减少;我们认为这两个都是对秘密行动委员会不利的证据。第二名潜水员在整个减压过程中持续疼痛和肌肉痉挛,但他没有出现运动、反射或括约肌异常。两位潜水员对非手术治疗反应良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of herniated intervertebral disks during saturation dives: a case report.

During research saturation dives at 5.0 and 5.5 atm abs, 2 divers developed an acute herniation of the nucleus pulposus of the L5-S1 intervertebral disk. In both cases the pain was severe enough to require intravenous morphine or intramuscular meperidine. Although the symptoms presented by these divers are frequently considered to be an indication for immediate surgical consultation, we decided that emergency decompression posed an unacceptable risk that decompression sickness (DCS) would develop in the region of acute inflammation. In both cases strict bedrest and medical therapy were performed at depth. In the first case, 12 h was spent at depth before initiating a standard U.S. Navy saturation decompression schedule with the chamber partial pressure of oxygen elevated to 0.50 atm abs. In the second case, a conservative He-N2-O2 trimix decompression schedule was followed to the surface. In both cases, no initial upward excursion was performed. The required decompression time was 57 h 24 min from 5.5 atm abs and 55 h 38 min from 5.0 atm abs. During the course of decompression, the first diver's neurologic exam improved and he required decreasing amounts of intravenous narcotic; we considered both to be evidence against DCS. The second diver continued to have pain and muscle spasm throughout decompression, however he did not develop motor, reflex, or sphincter abnormalities. Both divers have responded well to nonsurgical therapy.

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