Academic Respiratory Unit, University of Bristol, Bristol, UK.
Br J Hosp Med (Lond). 2024 Sep 30;85(9):1-13. doi: 10.12968/hmed.2024.0047. Epub 2024 Sep 13.
Spontaneous pneumothorax is an increasingly common clinical presentation, the management of which, until recent years, had remained unchanged for decades. A recent surge in pneumothorax research has produced the largest randomised controlled trials in the field yet and has revolutionised the management of spontaneous pneumothorax. The body of evidence supporting the introduction of conservative and ambulatory care in appropriate patients in recent guidelines now allows these patients, many of whom would otherwise have been admitted to hospital, to be managed in the outpatient setting and reduces their risk of complications compared to conventional chest drain insertion. In this review, we discuss recent advances in the management of pneumothorax and the evidence underpinning contemporary guidelines. We aim to equip physicians with the knowledge to engage their patients in the decision-making process regarding their pneumothorax, whilst keeping patient safety and patients' own preferences at the centre of their care.
自发性气胸是一种越来越常见的临床病症,其治疗方法在近几年之前数十年来一直没有改变。最近对气胸的研究大量增加,产生了该领域迄今为止最大规模的随机对照试验,彻底改变了自发性气胸的治疗方法。最近的指南中支持将保守和门诊治疗引入合适患者的证据体现在许多情况下,原本需要住院的患者现在可以在门诊进行管理,与传统的胸腔引流管插入相比,降低了他们发生并发症的风险。在这篇综述中,我们讨论了气胸管理的最新进展和支持当前指南的证据。我们的目标是让医生具备知识,使他们能够让患者参与有关气胸的决策过程,同时将患者安全和自身偏好放在治疗的中心位置。