Enderson B L, Abdalla R, Frame S B, Casey M T, Gould H, Maull K I
Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville.
J Trauma. 1993 Nov;35(5):726-9; discussion 729-30.
Occult pneumothorax is defined as a pneumothorax that is detected by abdominal computed tomographic (CT) scanning, but not routine supine screening chest roentgenograms. Forty trauma patients with occult pneumothorax were prospectively randomized to management with tube thoracostomy (n = 19) or observation (n = 21) without regard to the possible need for positive pressure ventilation, to test the hypothesis that tube thoracostomy is unnecessary in this entity. Eight of the 21 patients observed had progression of their pneumothoraces on positive pressure ventilation, with three developing tension pneumothorax. None of the patients with tube thoracostomy suffered major complications as a result of the procedure. Hospital and ICU lengths of stay were not increased by tube thoracostomy. Patients with occult pneumothorax who require positive pressure ventilation should undergo tube thoracostomy.
隐匿性气胸的定义为通过腹部计算机断层扫描（CT）检测到，但常规仰卧位胸部X线筛查未发现的气胸。40例隐匿性气胸的创伤患者被前瞻性随机分为接受胸腔闭式引流（n = 19）或观察（n = 21）两组，不考虑是否可能需要正压通气，以检验该情况下胸腔闭式引流不必要这一假设。观察的21例患者中有8例在正压通气时气胸进展，其中3例发展为张力性气胸。接受胸腔闭式引流的患者均未因该操作出现严重并发症。胸腔闭式引流未增加住院时间和重症监护病房（ICU）住院时间。需要正压通气的隐匿性气胸患者应接受胸腔闭式引流。
