Wong M K, Leung W C, Wang J K, Lao T T, Ip M S, Lam W K, Ho J C
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong.
Hong Kong Med J. 2006 Oct;12(5):375-80.
Recurrent pneumothorax is rare during pregnancy. We describe a Chinese woman, with a history of spontaneous pneumothorax managed with an intercostal drain, who developed a recurrent pneumothorax during her 32nd week of pregnancy. There is no consensus on management in this situation. We review the literature and discuss different management approaches. Thirty-six cases of antepartum pneumothorax have been reported in 31 case reports. An intercostal drain only (n=11) or surgeries (thoracotomy, n=9; or video-assisted thoracoscopy, n=2) were common treatment options with no surgical complications reported. Twenty-two (61%) patients progressed to a normal vaginal delivery, while the rest required forceps delivery (22%) or Caesarean section (14%). No single treatment option outweighed the others. There were no maternal or foetal complications reported in those who underwent antepartum surgical intervention. Surgical management of recurrent pneumothorax during pregnancy is well tolerated.
复发性气胸在孕期较为罕见。我们描述了一名中国女性，她有自发性气胸病史，曾接受肋间引流治疗，在妊娠32周时出现复发性气胸。对于这种情况的处理尚无共识。我们回顾了文献并讨论了不同的处理方法。31篇病例报告中共报道了36例产前气胸病例。常见的治疗选择包括单纯肋间引流（n = 11）或手术（开胸手术，n = 9；或电视辅助胸腔镜手术，n = 2），未报告手术并发症。22例（61%）患者顺产，其余患者需要产钳助产（22%）或剖宫产（14%）。没有一种治疗方法优于其他方法。接受产前手术干预的患者未报告母婴并发症。孕期复发性气胸的手术治疗耐受性良好。
