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气胸病例报告
Spontaneous pneumothorax Case: A male patient, 20 Years old, left chest pain with dyspnea after work hard. He came to our department for diagnosis. Physical examination Trachea shift to right, left lung percussion: tympanic resonance, auscultation: left lung breath sound disappear Diagnosis Spontaneous pneumothorax: pulmonary tissue or the visceral pleura ruptured spontaneously, or the bullae near the pulmonary surface ruptured spontaneously, to make the air from lung and bronchi comes into the pleura cavity formed pneumothorax, called spontaneous pneumothorax. Etiology Secondary spontaneous pneumothorax: patient with clear basic disease, such as COPD, TB, cancer Primary spontaneous pneumothorax : health, without acute or chronic lung disease, bullae under the pleura rupture without clear reason Primary spontaneous pneumothorax Characters: young man thin and tall routine X-ray shows no obvious lesion bullae under pleura can be seen Clinical presentation and sign 1 symptom: chest suppression, chest pain, shortness of breath, dyspnea, cyanosis, shock 2 sign: affected side thorax full, respiratory move decrease, intercostal space broadening, vocal fremitus decrease, percussion shows tympanic resonance, heart shift to health part Laboratory tests X-ray 1、no lung markings lucencies part 2、lung tissue compressed to hilum CT 1、low density contain air in pleura cavity 2、lung tissue compressed Treatment Conservative treatment: suitable for stable small amounts pneumothorax and light symptom closed pneumothorax. We advice to stay in bed, O2 supplement, analgesia. Exhaust treatment: (1) pleura puncture extraction for small amounts pneumothorax, light symptom and well cardiopulmonary functional closed pneumothorax patient. (2) thoracic closed drainage for unstable, dyspnea, heavy symptom or tension pneumothorax patient. Health Education 1、treat primary disease actively 2、avoid factors
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