Haciibrahimoglu G, Cansever L, Kocaturk C I, Aydogmus U, Bedirhan M A
Yedikule Hospital for Chest Disease and Thoracic Surgery, Department of Thoracic Surgery, Istanbul, Turkey.
Thorac Cardiovasc Surg. 2005 Aug;53(4):240-2. doi: 10.1055/s-2005-837647.
Spontaneous hemopneumothorax is a rare disorder, occurring in 1% to 12% of patients with spontaneous pneumothorax. The present review was undertaken to emphasize the potential life-threatening condition of spontaneous hemopneumothorax and reassess the benefit of conservative treatment with chest tube drainage.
From 1997 to 2002, 291 cases of spontaneous pneumothorax were treated in our department. Of these, 9 (3.09%) developed hemopneumothorax (> 400 ml). The clinical features of these patients and the results of conservative and surgical management were retrospectively reviewed.
Seven patients were treated conservatively and two required VATS and thoracotomy because of worsening clinical condition. The amount of aspirated blood ranged from 400 to 3700 ml (mean, 1533 ml). Six patients received a homologous blood transfusion.
In conclusion, hemopneumothorax is a serious condition complicating spontaneous pneumothorax. Conservative treatment is adequate in most cases and should be performed if bleeding persists for less than 24 hours after chest tube placement.
自发性血气胸是一种罕见疾病，在自发性气胸患者中发生率为1%至12%。本综述旨在强调自发性血气胸潜在的危及生命状况，并重新评估胸腔闭式引流保守治疗的益处。
1997年至2002年，我科共治疗291例自发性气胸患者。其中，9例（3.09%）发生血气胸（>400 ml）。对这些患者的临床特征以及保守治疗和手术治疗结果进行回顾性分析。
7例患者接受保守治疗，2例因病情恶化需行电视辅助胸腔镜手术（VATS）及开胸手术。抽出的血量为400至3700 ml（平均1533 ml）。6例患者接受了同种异体输血。
总之，血气胸是自发性气胸的一种严重并发症。多数情况下保守治疗足够，如果胸腔置管后出血持续少于24小时，应采取保守治疗。
