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自发性血气胸的急诊手术

Emergency surgery for spontaneous hemopneumothorax.

作者信息

Tulay Cumhur Murat, Aygün Mert

机构信息

Department of Thoracic Surgery, Sanlıurfa Teaching and Research Hospital, Sanlıurfa, Turkey.

出版信息

J Coll Physicians Surg Pak. 2014 Jun;24(6):435-347.

Abstract

Emergency management of spontaneous hemopneumothorax patients was retrospectively analysed in this study. From November 2009 to August 2012, 221 patients with spontaneous pneumothorax were treated in the thoracic surgery clinic. Among them, 9 (4.07%) were diagnosed with spontaneous hemopneumothorax. Chest X-ray and computed tomography were the diagnostic tools. Emergency thoracotomy was performed for 7 of 9 patients because of massive hemothorax and continuous bleeding from the chest tube. Massive hematoma was documented in 2 of 7 patients at tomography. Bridging veins and torn pleural adhesion between parietal and visceral pleura were the source of bleeding determined at thoracotomy. Hematoma evacuation, resection of bullae, ligation of pleural adhesions and apical pleurectomy were performed. Spontaneous hemopneumothorax is an emergency due to massive hemorrhage and hematoma formation. Early surgical treatment is recommended for patients with spontaneous hemopneumothorax.

摘要

本研究回顾性分析了自发性血气胸患者的急诊处理情况。2009年11月至2012年8月,胸外科门诊共治疗221例自发性气胸患者。其中,9例(4.07%)被诊断为自发性血气胸。胸部X线和计算机断层扫描为诊断手段。9例患者中有7例因大量血胸及胸腔引流管持续出血而行急诊开胸手术。7例患者中的2例在断层扫描时记录有大量血肿。开胸手术确定桥静脉及壁层胸膜与脏层胸膜之间撕裂的胸膜粘连为出血来源。进行了血肿清除、肺大疱切除、胸膜粘连结扎及胸膜顶切除术。自发性血气胸因大量出血和血肿形成而属急症。对于自发性血气胸患者,建议早期手术治疗。

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