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Your condition is mild, treatment usually is one such expert:
Respondents: Zhang Guohui - Urology 12:45
Brother, I'm 16, my last was 60% of the more serious. You do not need to deal with pneumothorax, is to look at raising a good body, I am wrong you should be tall and thin it, lean people susceptible to this disease will not relapse gained over point, do strenuous exercise. I was strenuous exercise, Tubes exhaust made less than 20 days and tomorrow to the hospital for chest surgery yet.15 to 22 years of age is a high incidence of pneumothorax, the mortality rate of basic compression 0 I 92% pneumothorax, pulmonary bulla resection were made, a moderate surgery. Your condition is too mild for the first time I drain the tears in your first take the scissors between bone (really is scissors, Khan) bypassed a hole, and then inserted to 10 cm long tube the thickness of an ordinary ballpoint pen. The second drainage from the lacrimal bone thickness of a finger inserted into the bottom of the tube! Inserted 20 cm! MD hurts like me .
Respondents: IRF540 - four 23:12
Disease summary
Spontaneous pneumothorax due to lung disease is the lung tissue and rupture of the visceral pleura, or near the surface of the fine pulmonary emphysema bubble burst, the air inside the lung and bronchus into the pleural cavity Plaza. More common in men, young or suffering from chronic bronchitis, emphysema, tuberculosis who. The disease is one of Pulmonary acute, severe cases can be li


fe threatening, in time be cured. Clinical manifestations 1. Sudden chest pain, difficulty breathing, chest tightness, severe irritability, sweating, cyanosis, breath and pulse of the fine speed, and even shock. 2. Tracheal shift to the contralateral, ipsilateral chest full, breathing exercises reduced or lost, was drum percussion sounds, words, and breath sounds less chatter. Diagnosis is based . A sudden chest pain, difficulty breathing, chest full of the affected side, percussion drum sound, auscultation breath sounds disappeared. 2. Chest radiograph or chest see chest product gas. 3. Or in the chest with a syringe pumped gas. Treatment principles 1. Pneumothorax with a small amount of exhaust treatment can be closed. Open pneumothorax must be closed drainage.
Disease Information 2. Pneumothorax should do an emergency high-pressure exhaust, made after closed drainage. 3. Treatment of the primary disease. Drug Principles 1. The primary disease of TB are isoniazid corpus application, rifampicin, streptomycin, pyrazinamide and other anti-tuberculosis treatment. 2. Has infected application of penicillin, Pioneer will prime and so on. 3. Attack many times or those in poor drainage treatment can be applied to tetracycline powder, thrombin, such as talcum powder pleurodesis surgery. Auxiliary examinati. Pneumothorax chest film examination must be done, if the critical condition can be temporary for chest; 2. Differential treatment of recurrent disease should be assisted thoracic or thoracic imaging, CT and other tests. Spontaneous clinical symptoms and signs often not typical, often overshadowed by the original disease. There are about 1 / 4 slow onset cases,
Symptoms gradually worsened, mainly for the primary disease, increased unexplained shortness of breath; in some cases there is no clear incentive to look for disease, manifested as a sudden or rapid increase in chest tightness and shortness of breath; 40% to 60% of cases with sudden severe cough was significantly The shortness of breath, chest tightness, palpitation and dyspnea. Physical activity can also be due to small number of patients, forced defecation, sneezing, weight and other factors induced. Chest pain, especially sharp sudden pain in a typical pneumothorax is rare. Other common symptoms include cough, cyanosis, and can not be supine and so on. Cough can be irritating cough can also be due to underlying diseases while sputum. Large pneumothorax or tension pneumothorax sometimes resembles the clinical manifestations of pulmonary infarction or myocardial infarction, early stage chest tightness, chest pain, dyspnea, palpitation, sweating, pallor, irritability. Few obvious signs of pneumothorax; more than 30% of lung compression, the tracheal shift to the contralateral, ipsilateral thoracic bulging, weakened respiratory movement, percussion drum sound was the heart dullness liver dullness disappear or down, breathing sound and language flutter reduced or lost, it is sometimes easy to be confused with emphysema. Some elderly patients is similar to asthma-like attack, severe breathing difficulties, while the lungs could be heard wheezing. Many such patients with severe emphysema Department, pulmonary insufficiency, but also more room separated pleural adhesions. Pneumothorax drainage in such patients shortness of breath and wheeze rapidly disappearing. Pulmonary function tests: often more than 20% pneumothorax when the compression may be restrictive ventilatory impairment (reduced lung capacity and vital capacity). Old pneumothorax because the presence of underlying disease, often in less than 20% of lung compression had severe pulmonary dysfunction. Were not clinically suspected pneumothorax lung function were forced expiratory action project inspection, so as not to exacerbate the condition. Arterial blood gas examination: Development of pneumothorax in patients with acute collapse because of invalid perfusion lung tissue, causing right to left shunt and hypoxemia occur. Since the late collapse the lung blood flow, hypoxemia but can be mitigated. Pneumothorax usually in the lungs of young people is compressed 20% to 30% or more to appear hypoxemia. Spontaneous pneumothorax by lung compression often occurs when mild hypoxemia. X-ray examination: the typical X-pneumothorax lung collapse cylindrical ball to the hilar shadow, the gas often gathered in the lateral or the apex of the chest, through the Ministry of increased brightness, no lung pattern. Pneumothorax and pulmonary extension of the lower display when the sharp costophrenic angle. A small amount of product gas and more limited pneumothorax apex, easily concealed video clavicle. At this point, deep X-ray findings of expiratory diagnosis. Part of spontaneous pneumothorax in patients with pleural adhesions separated and presented as a "limited pneumothorax", product gas may be pulmonary or mediastinal shadow cover, turn the position fluoroscopy can only be found. Cause of pleural disease is dirty - a closed parietal pleural cavity. Because lung recoil force
Disease because it is a negative pressure chamber [-0.29 ~ 0.49kPa (-3.5cmH2O). When the incentive to cause a sharp rise in alveolar pressure, the lesions of the lung - pleural rupture, chest cavity open to atmosphere, air will flow into the chest and the formation of spontaneous pneumothorax. Mostly secondary spontaneous pneumothorax, because part of the lung tissue of patients with parietal pleural adhesions have been, pneumothorax fistula rupture of lung tissue to form holes or small holes can not bronchial fistula closed with lung compression, leading to fistula holes remain open, pleural pressure close to zero, and to become "open pneumothorax"; some patients because of bronchial stenosis, half blocking the formation of valve-like, so that breathing the air into the chest, exhale is still missed here, pleural pressure can be more than 1.96kPa (20cmH2O), a "tension pneumothorax"; For these reasons, spontaneous pneumothorax often difficult to heal, recurrence of pneumothorax, localized pneumothorax more common, and simple type of pneumothorax but closed lower. Pathophysiology of pneumothorax treatment, except for injury or artificial pneumothorax, but are referred to as spontaneous. Most of the spontaneous rupture of subpleural emphysema caused by foam, is also found in the pleural cavity under the lesions or ulceration, pleural adhesions tearing and other reasons. Subpleural emphysema bubbles can be congenital, but also for acquired; the former Department of congenital dysplasia of elastic fibers and alveolar wall elasticity loss, after the formation of bulla expansion, more common in thin-type males, no significant lung X-ray examination disease. The latter was more common in post-obstructive pulmonary emphysema or inflammatory lesions on the basis of fibers, the bronchial semi-blocked, distorted, resulting in the formation of emphysema bubble valve mechanism, swollen bubble emphysema due to nutrition, circulation disorder deflected line variability that increased pressure in the lungs when coughing or rupture. Diagnosis of clinical diagnosis of spontaneous pneumothorax is very typical, easily concealed and the primary disease misdiagnosis or missed diagnosis. Patients should be considered when the following conditions can pneumothorax: sudden unexplained dyspnea, or difficulty in breathing on the basis of the original sudden shortness of breath increased, with primary disease who can not be explained;
Check the choke with sudden severe chest breathing difficulties, except for myocardial infarction and pulmonary infarction are; progressive disease of unknown cause deterioration in the short term palpitation, sweating, pale or cyanotic, and (or) impaired consciousness; sudden increase asthmatic symptoms, lung or single lung full of wheeze, and various antispasmodic drugs, corticosteroids, oxygen therapy and antibiotics ineffective; rapid or progressive worsening cyanosis. Pressure can also distinguish between pneumothorax pneumothorax machine types: closed pneumothorax: pleural cavity before the exhaust pressure close to or slightly higher than the atmospheric pressure, exhaust pressure decreased after the pleural cavity, and stop the rise in exhaust back pressure. Chest compression of this type of gas is usually 1. Other laboratory examinations 1.X-ray diagnosis of pneumothorax is the most reliable way to show the degree of lung atrophy, with or without pleural adhesions, mediastinal shift, and pleural effusions. Enhance the transparency of pneumothorax side, no markings, hilar pulmonary atrophy in the Ministry, and pneumothorax effect a clear boundary edge of thin strip lung, contralateral mediastinal shift may, in particular, tension pneumothorax is more significant; pneumothorax occupies a small amount of lung sharp parts, so that apex to the hilum tissue pressure; if you see liquid liquid pneumothorax plane.
Inspection program 2.CT on the diagnosis of intrathoracic small amount of gas is more sensitive. Of recurrent pneumothorax, chronic lung pneumothorax were observed whether the edge of the lesions caused by pneumothorax, such as bullae, pleural adhesion belt, lungs stretch, rip so easily closed. Intrapleural pneumothorax occurs as the basic performance of very low density of the gas film, accompanied by lung tissue changes in different degrees of compression atrophy. 3. Pleural cavity pleural contrast this method to clear the surface of the case, easy to clear the cause of pneumothorax. When the compression area of the lung in 30% to 40% of the line imaging is appropriate, the performance of the lobe bullae within the contours of single or multiple cystic low density; pleural fissure showed the phenomenon of bubbling spray, especially when patients cough , due to pulmonary hypertension, the more obvious signs. 4. Thoracoscopic it easier to find the cause of pneumothorax, flexible operation, up to interlobar fissure, apex, hilum, almost no blind spot, whether the gap observed visceral pleura, subpleural bullae and with or without chest with or without adhesions. Differential diagnosis of spontaneous pneumothorax is sometimes required to be differentiated with the following diseases:
Diagnosis 1. Pneumothorax secondary to exacerbation of COPD, closed pneumothorax, and sometimes even open pneumothorax is often mistaken for exacerbation of COPD. Pneumothorax in patients with shortness of breath prominent, and more for the sudden or progressive increase, while cough, sputum correspondingly less; COPD exacerbation of climate change is often an incentive, the above sense as the guide, the most prominent cough, sputum increased, purulent sputum. Product gas sign is limited or unilateral, bilateral asymmetry, and the symptoms of lung hyperinflation is more diffuse, bilaterally; emerging tracheal shift is strong evidence of pneumothorax. X-ray examination and if necessary, artificial pneumothorax machine diagnostic puncture and manometry can help confirm the diagnosis. 2. Bullae or limitations of a small amount of pneumothorax and lung bullae sometimes be differentiated. Slow the development of bullous lung disease, clinical manifestations tend to be more stable; X-ray brightness on the increase in the region through the still small stripes visible shadow, repast chest lesions relatively little change; after the diagnostic biopsy bullae shadow exhaust same size different from the pneumothorax. 3. Pleural effusion pleural effusion are usually manifested in patients with chest pain and shortness of breath, but the physical examination and X-ray examination but do not sign for the fluid in the pneumothorax. 4. Myocardial infarction, pulmonary infarction tension pneumothorax sometimes resembles the clinical manifestations of myocardial infarction, pulmonary infarction, are manifested as sudden severe chest pain, shortness of breath, difficulty breathing, palpitation, pale or cyanosis, sweating, irritability, etc., but the tension pneumothorax was ipsilateral thoracic gas volume and airway symptoms may help differentiate the opposite shift, X-ray diagnostic machines and artificial pneumothorax puncture can be confirmed. 5. Bronchial asthma is similar to the performance of some elderly patients with pneumothorax, asthma-like attack, severe breathing difficulties, while the lungs could be heard wheezing. Thoracic gas volume levy of antispasmodic agents - corticosteroids - oxygen is invalid, exhaust and breathing difficulties after the disappearance of another wheeze in asthma. Treatment 1. As a general respiratory clinic routine. 2. Bed rest, if necessary, with a small amount of sedatives. 3. If shock, should be corrected as soon as possible, in addition to the general anti-shock measures, tension pneumothorax caused by the shock, should an emergency exhaust decompression; pneumothorax caused by blood, should be the treatment of hemorrhagic shock. For closed thoracic drainage in 1 to 2 days to do chest drainage of blood, such as bleeding, thoracic surgery consultation should be requested to consider the rupture of thoracic vascular ligation and oral patch. 4. Pneumothorax treatment (1) Slope supine, oxygen. (2) exhaust decompression: the first artificial pneumothorax intrathoracic pressure measurement device, such as positive pressure ventilation immediately, each measured exhaust pressure of 300 ~ 500mi 1, until the pressure gauge close to zero to stop pumping. Remaining gas brooch 3 ~ 5min, to needle injection. If the pressure is once increased, compared with tension pneumothorax; such as the exhaust, although repeated, still no significant change in pressure, compared with traffic pneumothorax. Both should be replaced with closed thoracic drainage tube, if necessary suction. (3) mild (such as the lungs compress no more than 20%) were closed from time to spontaneous ventilation without obvious symptoms. The rest, self-absorption and recovery of gas. (4) medical treatment ineffective, thoracoscopic or open lung can be cleft repair surgery organizations. (5) chronic pneumothorax (3 months), with the vacuum aspiration; recurrent pneumothorax, can be very little in the gas when the intrathoracic injection of talc, Corynebacterium, or 50% glucose solution for the treatment of pleural adhesions. 5. Symptomatic treatment. May give codeine cough violently. Maintain a smooth stool, if necessary, to laxatives. 6. The primary disease treatment. Pleural cavity with antibiotics to prevent infection may be persons. 7. Cure standard clinical symptoms disappeared completely absorbed gas in the chest, lung tissue expansion well, can be considered cured. Complications 1. The incidence of pleural effusion in 30% to 40%, and more after the onset of the pneumothorax occurred 3 to 5 days, the amount is usually small, fluid not only increased atelectasis, pneumothorax for the open development of pus were also easy to pneumothorax. 2. Pus pneumothorax secondary to Staphylococcus aureus, anaerobes, or Gram-negative bacteria causing suppurative pneumonia, or lung abscess, pneumonia, pneumothorax, or cheese easy to merge pus pneumothorax. 3. Hemopneumothorax pneumothorax with pleural adhesion caused tearing of blood vessels in the result. The severity of the blood vessels and the tear size. Bleeding with a small contraction and endothelium of blood vessels which can be rolled automatically stop; large hemopneumothorax the abrupt onset, in addition to chest pain, chest tightness, shortness of breath, there are dizziness, palpitation, pale, cool skin, wet, blood pressure and other signs of hemorrhagic shock, X-ray examination shows liquid-gas surface, pleural aspiration for the whole blood. 4. Pneumothorax in patients with chronic pneumothorax part of the old basis of disease due to causes of pleural breach with the compression can not be closed; the formation of bronchopleural fistula is difficult to heal; bronchial stenosis or occlusion of leaving the lung can not re-inflated; visceral pleural thickening of the pulmonary muscular can not fully re-expansion, resulting in pneumothorax extend more than 3 months. 5. Mediastinal emphysema and more complicated in tension pneumothorax. No obvious symptoms of gas came from a can; and occurs more rapidly by gas will be a cycle - respiratory failure, the condition is extremely dangerous, medical shows cyanosis, jugular vein engorgement, stroke is not palpable, the heart dullness shrink or disappear, often with subcutaneous emphysema (local swelling, grip the snow with a sense of palpation, auscultation with crepitus), X-ray showed mediastinal shadow on both sides of the cable is bounded to the transparent zone. 6. Respiratory failure secondary to COPD, which is a common complication of elderly pneumothorax. 7. Circulatory failure and more complicated in tension pneumothorax. 8. Heart failure more common in elderly people with severe heart disease patients with pneumothorax. Pneumothorax caused by hypoxemia, infection, breathing exercises to increase oxygen consumption, arrhythmia and other factors can induce heart failure. Prognosis and Prevention Prognosis: spontaneous pneumothorax recurrence rate, 19% to 36%, of which nearly 70% of recurrence in six months and may relapse several times, especially given the general treatment or puncture only exhaust those pleurodesis surgery relapse rate low. The case fatality rate of pneumothorax was 9% ~ 32.9%. Mortality and proportional to the degree of lung compression, senior citizens, based on a serious disease, a complication of tension pneumothorax and sinister prognosis. The reason because the underlying disease of spontaneous pneumothorax, lung compression ratio is not that often severe breathing difficulties, the timely implementation of closed drainage will significantly affect the prognosis. Prevention: Prevention is the key to a positive pneumothorax primary disease prevention, in particular, COPD and respiratory infections. For bullae of the elderly, especially those with a history of pneumothorax should be kept smooth stool, avoid with respiratory irritant, avoid fatigue, and weight. Recurrent pneumothorax by pleurodesis surgery is the main method to prevent recurrence.


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