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新型冠状病毒肺炎感染中的气胸和纵隔气肿

Pneumothorax and Pneumomediastinum in SARS-CoV-2 Infection.

作者信息

Aldea Cătălina, Abdulan Irina Mihaela, Ciuntu Bogdan Mihnea, Negru Robert, Luca Cătălina Mihaela

机构信息

Doctoral School, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

Department of Medical Specialties I, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

出版信息

Medicina (Kaunas). 2025 Jun 29;61(7):1182. doi: 10.3390/medicina61071182.

Abstract

Infection with SARS-CoV-2, the etiologic agent of Coronavirus 2019, spread rapidly globally after the first case was reported in Wuhan, China. Multiple respiratory complications, including pneumothorax and pneumomediastinum, have been observed. This study presents an analysis of 100 patients diagnosed with these conditions in the context of SARS-CoV-2 infection. This study was conducted between March 2020 and February 2021 and included patients from two hospital units designated for the management of patients with SARS-CoV-2 infection. Demographic data, laboratory investigation results, imaging assessments, medical-surgical management strategies, and survival data were recorded. The study included 100 patients with confirmed SARS-CoV-2 infection (mechanically ventilated and non-ventilated). Of these, 57 patients presented with pneumothorax, 26 of whom also had associated pneumomediastinum and 43 of whom were diagnosed with pneumomediastinum alone. There was a higher incidence of pneumothorax among male patients. Also, 22 patients had concomitant subcutaneous emphysema. Regarding therapeutic management, 36 pleural drains were performed. Bilateral pneumothorax was identified in five patients. The presence of pneumothorax was correlated with a decreased survival rate among patients diagnosed with COVID-19. Also, performing pleural drainage in patients with pneumothorax and COVID-19 pneumonia did not significantly influence the prognosis of the underlying disease.

摘要

新型冠状病毒2019的病原体严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染在中国武汉报告首例病例后在全球迅速传播。已观察到多种呼吸道并发症,包括气胸和纵隔气肿。本研究对100例在SARS-CoV-2感染背景下被诊断患有这些病症的患者进行了分析。本研究于2020年3月至2021年2月进行,纳入了来自两个指定用于管理SARS-CoV-2感染患者的医院科室的患者。记录了人口统计学数据、实验室检查结果、影像学评估、内科-外科治疗策略和生存数据。该研究纳入了100例确诊SARS-CoV-2感染的患者(机械通气和非机械通气)。其中,57例患者出现气胸,其中26例还伴有纵隔气肿,43例仅被诊断为纵隔气肿。男性患者气胸的发生率较高。此外,22例患者伴有皮下气肿。关于治疗管理,进行了36次胸腔闭式引流。5例患者被确定为双侧气胸。气胸的存在与确诊为新型冠状病毒肺炎(COVID-19)的患者生存率降低相关。此外,对患有气胸和COVID-19肺炎的患者进行胸腔引流对基础疾病的预后没有显著影响。

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