Bouwmeester Noor H, Kieft Hans, Shahin Ghada Mm, Nierich Arno P
Department of Intensive Care, Isala, Zwolle, The Netherlands.
Department of Cardiothoracic Surgery, Isala, Zwolle, The Netherlands.
SAGE Open Med Case Rep. 2020 May 8;8:2050313X20918989. doi: 10.1177/2050313X20918989. eCollection 2020.
A 50-year-old human immunodeficiency virus positive patient who was diagnosed with Pneumocystis jirovecii pneumonia developed severe subcutaneous and mediastinal emphysema, which was progressive despite low pressure mechanical ventilation. Infraclavicular skin incisions and vacuum-assisted closure therapy were used to resolve the emphysema. The subcutaneous emphysema decreased significantly, and after 1 week the vacuum-assisted closure therapy was ended successfully. This technique has previously been described in several case reports, where it is a promising treatment in severe subcutaneous emphysema, but it is not yet widely used. This case report supports the further use of vacuum-assisted closure therapy in subcutaneous emphysema. Successful treatment of severe mediastinal and subcutaneous emphysema in Pneumocystis jirovecii pneumonia can be achieved by vacuum-assisted closure therapy on infraclavicular skin incisions.
一名50岁的人类免疫缺陷病毒阳性患者被诊断为耶氏肺孢子菌肺炎，出现了严重的皮下和纵隔气肿，尽管采用了低压机械通气，气肿仍在进展。采用锁骨下皮肤切口和负压封闭引流疗法来解决气肿问题。皮下气肿明显减轻，1周后成功结束负压封闭引流治疗。此前在几篇病例报告中已描述过该技术，它在严重皮下气肿的治疗中是一种有前景的治疗方法，但尚未得到广泛应用。本病例报告支持在皮下气肿中进一步使用负压封闭引流疗法。通过对锁骨下皮肤切口进行负压封闭引流治疗，可成功治疗耶氏肺孢子菌肺炎所致的严重纵隔和皮下气肿。
