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目的分析1例延误诊治的减压性骨坏死病例。方法结合患者的职业史、急性减压病病史和影像学检查资料,根据GBZ 24—2006《职业性减压病诊断标准》进行诊断。结果患者有明确的潜水作业史,有1979年从事潜水作业后减压不当导致急性减压病病史,主诉有双髋关节疼痛和左下肢行走困难,体格检查可见双髋关节活动受限和左下肢行走不利,双下肢和髋关节X射线摄片和CT检查可见特征性的股骨头和髋关节损害的影像学表现,经综合分析,没有证据否定其从事潜水作业(特别是有减压不当史)与其骨和关节损害之间的必然联系,诊断为职业性减压病(Ⅲ期减压性骨坏死)。结论诊断的延误不利于疾病的及时治疗,不利于控制病情进展和减少伤残发生。
Objective To analyze a case of delayed decompression osteonecrosis. Methods Combined with the occupational history of patients, the history of acute decompression sickness and imaging examination data, according to GBZ 24-2006 diagnostic criteria of occupational decompression sickness. Results The patients had a clear history of diving operations. There was a history of acute decompression sickness caused by improper decompression after diving operations in 1979. The chief complaint was double hip pain and difficulty in walking on the left lower limb. Physical examinations showed that the activities of the double hip joints were limited and the left lower extremities Walking adversely, both lower extremity and hip X-ray and CT examination can be seen characteristic femoral head and hip damage imaging performance, after a comprehensive analysis, there is no evidence to deny it engaged in diving operations (especially with improper decompression history) And the inevitable link between the bone and joint damage, diagnosis of occupational decompression disease (Ⅲ decompression osteonecrosis). Conclusion Delay in diagnosis is not conducive to the timely treatment of the disease, is not conducive to controlling the progression of the disease and reduce disability.