Dirol Hülya, Keskin Hakan
Department of Thoracic Disease, School of Medicine, Akdeniz University, Antalya, Turkey.
Department of Thoracic Surgery, School of Medicine, Akdeniz University, Antalya, Turkey.
J Cardiovasc Thorac Res. 2022;14(1):42-46. doi: 10.34172/jcvtr.2022.09. Epub 2022 Mar 15.
Pneumomediastinum (PM) is a self-limiting disease with a good prognosis. Mediastinitis is a rare but potentially fatal complication of PM. Identification of risk factors for mediastinitis is essential for better management. This is a single-center, retrospective study conducted in a university hospital. Adult patients with PM between January 2016 and June 2020 were involved in the study. The data about age, gender, symptoms, signs, treatment, development of mediastinitis, hospital stay, and mortality were investigated. In total, 79 patients with PM were analyzed. The most common symptom was dyspnea(58;73.4%) and the most common sign was subcutaneous emphysema (48;60.7%). Thirty(37.9%) of them were iatrogenic PM (IPM), while 22 (27.9%) were spontaneous PM (SPM) and27 (34.2%) were traumatic PM (TPM). Mediastinitis developed in 17 (12 from IPM, 4 from TPM,1 from SPM) patients, and 11 (58.8%) of these patients died. The incidence of mediastinitis in the IPM group was significantly higher than in the TPM and SPM group (respectively, = 0,03, = 0,01). There was no significant difference between the age, gender, symptoms, and signs of those with or without mediastinitis. Mortality was lower in TPM and SPM than IPM (respectively, = 0,05, = 0,03), and hematological malignancy was remarkably common in patients who died from mediastinitis in the TPM and SPM group. Mediastinitis and mortality were significantly higher in IPM, while hematological malignancy was remarkably prevalent in patients deceased from mediastinitis in TPM and SPM.
纵隔气肿（PM）是一种自限性疾病，预后良好。纵隔炎是PM罕见但可能致命的并发症。识别纵隔炎的危险因素对于更好的管理至关重要。这是一项在大学医院进行的单中心回顾性研究。纳入了2016年1月至2020年6月期间患有PM的成年患者。调查了有关年龄、性别、症状、体征、治疗、纵隔炎的发生、住院时间和死亡率的数据。总共分析了79例PM患者。最常见的症状是呼吸困难（58例；73.4%），最常见的体征是皮下气肿（48例；60.7%）。其中30例（37.9%）为医源性PM（IPM），22例（27.9%）为自发性PM（SPM），27例（34.2%）为创伤性PM（TPM）。17例患者发生了纵隔炎（IPM组12例，TPM组4例，SPM组1例），其中11例（58.8%）患者死亡。IPM组纵隔炎的发生率显著高于TPM组和SPM组（分别为P = 0.03，P = 0.01）。有无纵隔炎患者的年龄、性别、症状和体征之间无显著差异。TPM组和SPM组的死亡率低于IPM组（分别为P = 0.05，P = 0.03），TPM组和SPM组死于纵隔炎的患者中血液系统恶性肿瘤明显常见。IPM组纵隔炎和死亡率显著更高，而TPM组和SPM组死于纵隔炎的患者中血液系统恶性肿瘤明显普遍。
