气胸

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最后审阅: 9 Nov 2024
最后更新: 31 Jan 2023

小结

定义

病史和体格检查

关键诊断因素

  • 胸痛
  • 呼吸困难
  • 同侧呼吸音减弱
  • 同侧肺部过度充气且叩诊时有过清音
  • 缺氧
  • 存在的危险因素
  • 心肺功能恶化
  • 气管向对侧偏移
  • 出汗
完整详情

其他诊断因素

  • 咳嗽
完整详情

危险因素

  • 吸烟
  • 气胸家族史
  • 身材高瘦的体型
  • 年龄<40 岁
  • 近期接受过创伤性手术
  • 胸部外伤
  • 急性重症哮喘
  • 慢性阻塞性肺疾病 (COPD)
  • 结核
  • AIDS 相关的卡氏肺囊虫感染
  • 囊性纤维化。
  • 淋巴管肌瘤病
  • 马凡综合征
  • 高胱氨酸尿
  • 原发性肺癌和向肺部转移的癌症
  • Birt-Hogg-Dube 综合征
  • 肺部朗格汉斯细胞组织细胞增多症
  • Erdheim-Chester 病
完整详情

诊断性检查

首要检查

  • 胸部 X 线检查
  • 血液检测
完整详情

需考虑的检查

  • 胸腔超声
  • 胸部 CT
  • 动脉血气 (ABG)
完整详情

治疗流程

初步治疗

疑似张力性气胸

急症处理

确诊原发性自发性气胸

确诊继发性自发性气胸

确诊创伤性非张力性气胸

确诊阻塞性肺不张后气胸

持续性治疗

急性气胸消退

撰稿人

专家顾问

Jonathan Bennett, MD

Honorary Professor of Respiratory Sciences

University of Leicester

Respiratory Consultant

Glenfield Hospital

Leicester

UK

简介

JB is Chair of the British Thoracic Society (BTS). He is also deputy medical director RCP Invited service Reviews, and speaker at National Society (eg., BTS), Primary Care respiratory Society, Society Cardiothoracic Surgeons meetings.

利益声明

JB declares that he has no competing interests.

Claire Vella, MD, MRCP

Clinical Fellow Lung Cancer and Interventional Pulmonology

Glenfield Hospital

Leicester

UK

利益声明

CV declares that she has no competing interests.

Onyeka Umerah

Respiratory Registrar

Glenfield Hospital

University Hospitals of Leicester NHS Trust

Leicester

UK

利益声明

OU declares that she has no competing interests.

Acknowledgements

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:

Lonny Yarmus, DO, MBA

Associate Professor of Medicine and Oncology

Clinical Director, Division of Pulmonary and Critical Care

Director, Interventional Pulmonology Research Core

Johns Hopkins Medical Institutions

Baltimore

MD

Jason Akulian, MD, MPH

Assistant Professor of Medicine

Director, Interventional Pulmonology

Carolina Center for Pleural Disease

University of North Carolina

Chapel Hill

NC

利益声明

LY has received research grants and consulting fees from Olympus, Inc, the manufacturer of the Spiration intrabronchial valve. JA declares that he has no competing interests.

同行评议者

Matthew Knight, PGCertEd MD FRCP FRCP(Edin)

Associate Postgraduate Dean

Health Education England

Royal College of Physicians College Tutor

Consultant Respiratory Physician

Watford General Hospital

West Hertfordshire Hospitals NHS Trust

利益声明

MK was collaborator and site principal investigator for the randomised ambulatory management of primary pneumothorax (RAMPP) trial, which received funding from Rocket Medical. MK has attended meetings sponsored by Rocket Medical.

编辑

Annabel Sidwell

Section Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Anna Ellis

Head of Editorial, BMJ Best Practice

利益声明

AE declares that she has no competing interests.

Rachel Wheeler

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Julie Costello

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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