Pribadi Rabbinu R, Singh Gurmeet, Rumende Cleopas M
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2016 Jan;48(1):54-7.
Pneumothorax is the presence of air in the pleural space. Its management consists of noninvasive and invasive therapies and it is determined based on clinical manifestations, type and size of pneumothorax. We present a case of a patient with diagnosis of primary spontaneous pneumothorax treated with incentive spirometry (noninvasive therapy). A 20 year old man came to respirology clinic with chief complaint of shortness of breath. He was recently diagnosed with left pneumothorax based on previous chest X-ray in another health care facilities and was advised to undergo tube thoracostomy but he refused the procedure. On physical examination, vital signs were normal. Chest X-ray showed 33% of pneumothorax or 1.2 cm. He was asked to perform incentive spirometry therapy at home. During 12 days of therapy, shortness of breath slowly disappeared and on repeated chest X-ray, it showed minimal pneumothorax in the left upper hemithorax. Noninvasive treatment such as incentive spirometry can be considered in patient with minimal symptoms and no signs of life-threatening respiratory distress.
气胸是指胸膜腔内存在气体。其治疗方法包括无创和有创治疗，治疗方法的选择取决于临床表现、气胸的类型和大小。我们报告一例诊断为原发性自发性气胸的患者，采用激励肺活量测定法（无创治疗）进行治疗。一名20岁男性因气短为主诉前来呼吸内科就诊。他此前在另一家医疗机构进行胸部X线检查后，最近被诊断为左侧气胸，并被建议进行胸腔闭式引流术，但他拒绝了该手术。体格检查时，生命体征正常。胸部X线显示气胸占33%或1.2厘米。他被要求在家中进行激励肺活量测定法治疗。在治疗的12天里，气短症状逐渐消失，再次进行胸部X线检查时，显示左上胸腔仅有少量气胸。对于症状轻微且无危及生命的呼吸窘迫迹象的患者，可考虑采用激励肺活量测定法等无创治疗。
