Chu C M, Leung Y Y, Hui J Y H, Hung I F N, Chan V L, Leung W S, Law K I, Chan C S, Chan K S, Yuen K Y
Dept of Medicine, United Christian Hospital, Hong Kong SAR, China.
Eur Respir J. 2004 Jun;23(6):802-4. doi: 10.1183/09031936.04.00096404.
Spontaneous pneumomediastinum (SP) unrelated to assisted ventilation is a newly recognised complication of severe acute respiratory syndrome (SARS). The objective of the present study was to examine the incidence, risk factors and the outcomes of SP in a cohort of SARS victims from a community outbreak. Data were retrieved from a prospectively collected database of virologically confirmed SARS patients. One hundred and twelve cases were analysable, with 13 patients developing SP (11.6%) at a mean +/- SD of 19.6 +/- 4.6 days from symptom onset. Peak lactate dehydrogenase level was associated with the development of SP. SP was associated with increased intubation and a trend towards death. Drainage was required in five cases. For patients who survived, the SP and/or the associated pneumothoraces took a median of 28 days (interquartile range: 15-45 days) to resolve completely. In conclusion, spontaneous pneumomediastinum appeared to be a frequent complication of severe acute respiratory syndrome. Further research is needed to investigate its pathogenesis.
与辅助通气无关的自发性纵隔气肿（SP）是严重急性呼吸综合征（SARS）一种新发现的并发症。本研究的目的是调查社区爆发的SARS患者队列中SP的发生率、危险因素及转归。数据取自前瞻性收集的病毒学确诊SARS患者数据库。112例患者可进行分析，其中13例（11.6%）在症状出现后平均19.6±4.6天发生SP。乳酸脱氢酶峰值水平与SP的发生有关。SP与插管增加及死亡趋势相关。5例患者需要进行引流。存活患者的SP和/或相关气胸完全吸收的中位时间为28天（四分位间距：15 - 45天）。总之，自发性纵隔气肿似乎是严重急性呼吸综合征的常见并发症。需要进一步研究以探讨其发病机制。
