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[年轻大麻吸食者的气胸:附三例报告]

[Pneumothorax in young cannabis smokers: A propos of three cases].

作者信息

Chardon M-L, Dalphin J-C, Degano B

机构信息

Service de pneumologie, CHI Vesoul, 2, rue René-Heymes, 70000 Vesoul, France; Département des maladies respiratoires, centre hospitalier régional universitaire, 3, boulevard Alexandre-Fleming, 25030 Besançon, France.

Département des maladies respiratoires, centre hospitalier régional universitaire, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; UMR/CNRS 6249 chrono-environnement, centre hospitalier régional universitaire, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; Service de physiologie et explorations fonctionnelles, centre hospitalier régional universitaire, 3, boulevard Alexandre-Fleming, 25030 Besançon, France.

出版信息

Rev Mal Respir. 2018 May;35(5):556-561. doi: 10.1016/j.rmr.2018.04.007.

Abstract

INTRODUCTION

Cannabis consumption is common among adolescents and young adults in France. In addition to its neurological effect, cannabis smoking can induce severe pulmonary emphysema, even in young patients. When a spontaneous pneumothorax occurs in a cannabis smoker, the possibility of a secondary spontaneous pneumothorax should be considered. This may be of importance as management of secondary spontaneous pneumothorax may differ from the well-codified handling of primary spontaneous pneumothorax.

OBSERVATION

Clinical and radiological data from three young cannabis-using patients with spontaneous pneumothorax were collected. Given the presence of emphysema, they were all considered secondary spontaneous pneumothorax. Two patients underwent surgical treatment, with simple postoperative follow-up in one case and prolonged air leak in the other case. The management of the third patient, exclusively medical, was prolonged and complicated.

CONCLUSION

The presence of emphysema in young cannabis smokers complicates the management of spontaneous pneumothorax. In this context, a first-line surgical intervention may be an option to be considered.

摘要

引言

在法国,青少年和年轻人中吸食大麻的现象很常见。除了对神经系统有影响外,吸食大麻还会引发严重的肺气肿,即使是年轻患者也不例外。当大麻吸食者发生自发性气胸时,应考虑继发性自发性气胸的可能性。这一点可能很重要,因为继发性自发性气胸的治疗方法可能与已明确规范的原发性自发性气胸的处理方法不同。

观察

收集了三名吸食大麻的年轻自发性气胸患者的临床和放射学数据。鉴于存在肺气肿,他们均被视为继发性自发性气胸。两名患者接受了手术治疗,其中一例术后随访简单,另一例出现了长时间漏气。第三名患者仅接受药物治疗,治疗过程漫长且复杂。

结论

年轻大麻吸食者中肺气肿的存在使自发性气胸的治疗变得复杂。在这种情况下,一线手术干预可能是一个值得考虑的选择。

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