Platov I I, Moiseev V S
Probl Tuberk. 1998(5):61-2.
The authors present 7 cases with spontaneous pneumomediastinum (SPM), a rare pathological condition. The cause of SPM is rupture of marginal alveoles and spread of air into the mediastinum through perivesical and peribronchial fats. Males are more frequently affected, but females were prevalent in this study (as 4:3). At the stage when air does not spread outside the mediastinum, Hamman's sign, i.e. "crepitation" ("a crunching sound", "a noise of air bursting bubbles") heard at cardiac auscultation is significant in the diagnosis. Dissection of air in all mediastinial structures, which is detectable during X-ray studies both at this stage of SPM, and at the stage of spread of air to the neck, chest, and abdomen is an important diagnostic sign. The evolution of SPM is generally good and conservative therapy leads to recovery in most patients. In 9-16% of patients, the evolution of the process is dramatic and requires cervical mediastinotomy after Tiegel or thoracotomy with wide mediastinotomy.
作者报告了7例自发性纵隔气肿（SPM）病例，这是一种罕见的病理状况。SPM的病因是肺泡边缘破裂，空气通过膀胱周围和支气管周围的脂肪扩散至纵隔。男性更易患病，但在本研究中女性更为常见（比例为4:3）。在空气尚未扩散至纵隔外的阶段，心脏听诊时听到的Hamman征，即“捻发音”（“嘎吱声”，“空气泡破裂的声音”）对诊断具有重要意义。在SPM的这个阶段以及空气扩散至颈部、胸部和腹部的阶段，X线检查可发现纵隔所有结构内的气体分离，这是一项重要的诊断体征。SPM的病情发展通常良好，大多数患者采用保守治疗即可康复。在9% - 16%的患者中，病情发展较为严重，需要在Tiegel术后进行颈部纵隔切开术或进行广泛纵隔切开术的开胸手术。
