McRoberts R, McKechnie M, Leigh-Smith S
Emergency Department, The Royal Infirmary, Edinburgh, UK.
Emerg Med J. 2005 Aug;22(8):597-8. doi: 10.1136/emj.2004.018598.
A case is presented of unilateral tension pneumothorax associated with flail chest and pulmonary contusions in a spontaneously ventilating patient after a fall. The tension element was not suspected until chest x ray was available, nor was immediate needle thoracocentesis performed. No morbidity resulted as a consequence. This case highlights the difficulty in deciding whether or not tension pneumothorax is the predominant cause of respiratory distress in a patient with multiple chest injuries. It provides further evidence challenging some of the doctrine on how to treat suspected tension pneumothorax.
本文报告一例在跌倒后自主通气的患者中，单侧张力性气胸合并连枷胸和肺挫伤的病例。在获得胸部X线检查结果之前，未怀疑存在张力性因素，也未立即进行胸腔穿刺针吸术。结果未导致任何并发症。该病例突出了在判定张力性气胸是否为多发胸部损伤患者呼吸窘迫的主要原因时存在的困难。它提供了进一步的证据，对一些关于如何治疗疑似张力性气胸的学说提出了挑战。
