Robertson H T, Lakshminarayan S, Hudson L D
Thorax. 1978 Apr;33(2):175-80. doi: 10.1136/thx.33.2.175.
The pulmonary complications of a 50-metre fall to the water (a form of suicide attempt producing 87% mortality) were studied in 15 survivors. Presenting findings included crackles, haemoptysis, and hypotension. The alveolar-arterial oxygen difference was greater than 150 mmHg (20 kPa) in nine subjects on admission. Ventilatory failure developed in 10 of the patients, including all of those with massive haemoptysis. Radiographic findings included pneumothorax and diffuse pulmonary opacities adjacent to the area of impact. Pneumothorax developed within 12 hours of admission in 10 of 15 subjects but was associated with rib fractures in only four subjects. The clinical course of the condition is consistent with the hypothesis that the traumatic pulmonary tears produced interstitial emphysema, with subsequent development of pneumomediastinum, subcutaneous emphysema, and pneumothorax. Pneumothorax is a common complication of severe lung contusion even in the absence of penetrating pleural injury.
对15名从50米高处坠入水中（一种自杀未遂形式，死亡率达87%）的幸存者的肺部并发症进行了研究。呈现出的症状包括啰音、咯血和低血压。9名受试者入院时肺泡-动脉氧分压差大于150 mmHg（20 kPa）。10名患者出现呼吸衰竭，包括所有咯血量大的患者。影像学表现包括气胸以及撞击部位附近的弥漫性肺实质模糊影。15名受试者中有10名在入院后12小时内出现气胸，但仅4名受试者伴有肋骨骨折。该病症的临床病程与外伤性肺撕裂导致间质性肺气肿，随后发展为纵隔气肿、皮下气肿和气胸这一假说相符。即使没有穿透性胸膜损伤，气胸也是严重肺挫伤的常见并发症。
