Cabrera-Cordero José A, Adefna-Pérez Radamés I, Leal-Mursulí Armando, Castellanos-González Juan Antonio, Izquierdo-Lara Francoise T, Cabrera-Alfonso Suset
Servicio de Cuidados Intensivos, Hospital Clínico Quirúrgico Docente Dr. Miguel Enríquez, Ciudad de la Habana, Cuba.
Cir Esp. 2008 Oct;84(4):221-5. doi: 10.1016/s0009-739x(08)72623-x.
The respiratory system still continues to be a common place which deteriorates in HIV patients. Among the signs and symptoms, is the occurrence of a pneumothorax due to trauma and infections and is a cause of aggravation for these patients. The present study attempts to identify and characterise the behaviour of a group of variables in HIV patients with this complication.
An observational, descriptive case series study was carried out. The desired variables were obtained from clinical records.
Of the total number, 91.67% were males, and the mean age was 32.17 years. The main causes of pneumothorax were infections, particularly due to Pneumocystis jirovecii and deep venous catheterisation. A persistent statistically significant air leak was present in 33.3% of patients and two cases of pleural sepsis. Four patients died, all with acute respiratory failure and bacterial bronchopneumonia.
The majority were males in the third decade of life, AIDS patients. The main causes of the pneumothorax were infections and catheterisation of the subclavian vein. Immunodepression played a significant prognostic role in the progression and outcome of the patient. Minimum pleurotomy continues to be the first treatment option in these patients, due to their precarious general state which contraindicates a major procedure. The most frequent complication was the persistent air leak, being a significant indicator of a poor prognosis in the progress of these patients. Causes of death such as acute respiratory failure and bilateral bronchopneumonia prevailed.
呼吸系统仍是HIV患者病情恶化的常见部位。在体征和症状中，因创伤和感染导致的气胸较为常见，这也是这些患者病情加重的一个原因。本研究旨在识别并描述一组患有该并发症的HIV患者的变量行为。
开展了一项观察性、描述性病例系列研究。所需变量从临床记录中获取。
在总数中，91.67%为男性，平均年龄为32.17岁。气胸的主要原因是感染，尤其是卡氏肺孢子菌感染和深静脉置管。33.3%的患者存在持续具有统计学意义的气胸漏气，并有2例发生胸膜脓毒症。4例患者死亡，均死于急性呼吸衰竭和细菌性支气管肺炎。
大多数为处于第三年龄段的男性艾滋病患者。气胸的主要原因是感染和锁骨下静脉置管。免疫抑制在患者的病情进展和转归中起重要的预后作用。由于患者总体状况不稳定，禁忌进行大型手术，因此最小限度的胸膜切开术仍是这些患者的首选治疗方法。最常见的并发症是持续性气胸漏气，这是这些患者病情进展中预后不良的重要指标。急性呼吸衰竭和双侧支气管肺炎等死亡原因较为常见。
