Spontaneous pneumothorax report of 34 cases _2928

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Spontaneous pneumothorax report of 34 cases

Key words pneumothorax our hospital in November 2005 ~ October 2006 were a spontaneous pneumothorax treated 34 patients and achieved a more complete clinical information, are on their clinical characteristics, treatment methods and results and related factors were retrospectively analyzed and discussed. 1 clinical data 1.1 General Information The group of 34 patients were in November 2005 ~ October 2006 in our hospital diagnosed with spontaneous pneumothorax in patients, in line with idiopathic pneumothorax diagnostic criteria [1]. 34 patients were 28 males and 6 females, ages 16 to 36 years old, average 24.2 years old. Chinese papers League finishing. 1.2 incentives, the type of pneumothorax , pneumothorax and pulmonary parts strenuous exercise before the onset of compression in 6 cases, 2 cases of coughing, laughing loudly in 1 case, bowel movement in 3 cases, 1 case of a knife when cutting vegetables The remaining 21 cases no obvious causes. Simple pneumothorax in 28 cases, 4 cases of traffic pneumothorax, tension pneumothorax in 2 cases, left pneumothorax in 18 cases, 14 cases of right pneumothorax, bilateral pneumothorax in 2 cases, initial anteroposterior chest X-ray shows lung compression 80% in 5 cases. In 34 patients, with a small amount of pleural effusion in 3 cases, patients with pulmonary bulla. 1.3 Treatment methods and results 1.3.1 conservative treatment of the 8 cases of pulmonary compression <20> 80% of 2 cases of tension pneumothorax, take the 2nd intercostal space mid clavicular line or the 4th intercostal space anterior axillary line, skin disinfection, local anesthesia 2% lidocaine directly after needle puncture into the pleural cavity, puncture the number of 1 to 5 times the exhaust, of which 20% of 8 cases of lung compression ~ 50% and 3 cases of pulmonary compression 50% to 80% of patients, the first pumping X-ray the day after the review, the affected side than before obviously reexpansion lung, combined with oxygen therapy, the gas in the chest after 3 weeks of basic absorption. The other 3 cases of lung compression 20% to 50% and 1 case of pulmonary compression 50% to 80% of patients, the puncture after the poor efficacy exhaust, 2 cases of tension pneumothorax in patients with pleural puncture by an emergency pumping, the effective relief of the patient shortness of breath, choking sensations, to prevent possible shock and even death. 1.3.3 closed thoracic drainage in 3 cases of pulmonary compression of 20% to 50%, 4 cases of lung compression 50 % to 80% and 5 cases of lung compression> 80% of patients, taking mid clavicular line 2 intercostal anterior axillary line 4 or 5 bottles of intercostal catheter connected seal, closed thoracic drainage time from intubation to extubation was 4 to 15 days, including 3 patients with pulmonary compression 20% to 50%, 3 cases lung compression 50% to 80% and 4 cases of lung compression> 80% of patients, ipsilateral reexpansion pulmonary basic, and 1 case of pulmonary compression 50% to 80% and 1 lung compression> 80% of patients, the pleural closed drainage, continuous drainage of 1 week is still leaking, so the poor efficacy. 1.3.4 Surgical treatment of pulmonary compression of the group 1 patients 50% to 80% of patients and another 1 case of lung compression> 80% of patients, chest CT examination revealed bullae, the chest closed poor drainage effect, consider traffic pneumothorax, line VATS resection of lung bullae lung surface cracks repair,[link widoczny dla zalogowanych], the postoperative follow-up , were cured. 2 discussions primary spontaneous pneumothorax, also known as pneumothorax, which means routine lung X-ray examination failed to find significant pneumothorax occurred in lesions, occur in the young people [1]. The average age of 24.2 years in patients, in line with the above conclusion. Vanderscheren under thoracoscopic lung lesions and pleural adhesions in the case, will be spontaneous pneumothorax is divided into four clinical: Ⅰ level for spontaneous pneumothorax, were observed within the lung tissue was normal; Ⅱ level for pneumothorax associated with dirty layer, the parietal pleural adhesions; Ⅲ level as the visceral pleura and the diameter of bullae 2 cm of lung bullae [1]. Now that young people with spontaneous pneumothorax may be caused by rupture of subpleural bullae. The group of 34 patients, found by chest CT examination after 4 cases of lung bullae.