Fleegler B, Fogarty C, Owens G, Cohen E, Cassileth P A
Arch Intern Med. 1980 Mar;140(3):414-5.
Pathologic flail chest complicated the initial presentation of multiple myeloma in two patients. Both had severe hypercalcemia and diffuse bone disease. Atelectasis and pulmonary edema preceded the appearance of flail chest in one patient; atelectasis complicated the flail chest in the second patient and increased the severity of the flail. Both were treated with radiotherapy and chemotherapy. However, delay in stabilizing the first patient's chest wall with positive airway pressure was followed by extension of the flail chest and irreversible respiratory failure. On the other hand, prolonged stabilization of the chest wall in the second patient until a chemotherapy-induced remission occurred was associated with resolution of the flail chest.
两名患者在多发性骨髓瘤初次发病时出现了病理性连枷胸。两人均有严重高钙血症和弥漫性骨病。其中一名患者在连枷胸出现之前发生了肺不张和肺水肿；另一名患者的连枷胸合并了肺不张，加重了连枷胸的严重程度。两人均接受了放疗和化疗。然而，第一名患者在使用气道正压稳定胸壁方面出现延迟，随后连枷胸范围扩大并出现不可逆呼吸衰竭。另一方面，第二名患者胸壁长期稳定，直至化疗诱导缓解，连枷胸随之消退。
