closed pneumothorax
Introduction
Introduction to closed pneumothorax Closed pneumothorax refers to the rupture of lung tissue and visceral pleura under the action of no traumatic factors. The pleural effusion caused by gas entering the pleural cavity is one of the most common spontaneous pneumothorax. After the ventral tissue of the thoracic cavity is ruptured, the gas enters the pleural cavity, and the affected lung is compressed and collapsed, and the rupture port is closed by compression, so that the rupture of the rupture is no longer leaked, and the gas in the pleural cavity is no longer increased, forming a closed pneumothorax. At this time, the intrathoracic pressure is a positive pressure. Due to the unbalanced chest pressure on both sides, the mediastinum was moved to the healthy side. During the respiratory movement, the changes in the pressure in the thoracic cavity on both sides were close, and the mediastinum did not swing significantly. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific people Mode of infection: non-infectious Complications: rib fracture
Cause
The cause of closed pneumothorax
Air enters the wound (37%):
Closed pneumothorax is a complication of rib fracture. For example, a lung fissure has air sent to the pleural cavity, and the cleft is closed and no air leaks. Or a small chest wall penetrating wound, the wound is small, the air once enters the pleural cavity, and the chest wall The wound is closed immediately, the pleural cavity is no longer connected to the outside world, and it is also seen in iatrogenic injuries such as neck, chest invasive examination and chest acupuncture.
Pathogenesis:
Closed pneumothorax refers to the leaking channel that causes the pneumothorax to be closed, and no gas continues to leak into the pleural cavity. After the rupture of the gas-containing tissue in the thoracic cavity, the gas enters the pleural cavity, and the affected lung is compressed and collapsed, and the rupture is closed by compression, so that the rupture of the rupture is no longer leaked, and the gas in the pleural cavity is no longer increased, forming a closed pneumothorax. At this time, the intrathoracic pressure is positive pressure. Because the pressure on both sides of the chest is unbalanced, the mediastinum is pushed to the healthy side. During the respiratory movement, the pressure changes in the chest cavity on both sides are close, and the mediastinum has no obvious swing.
Prevention
Closed pneumothorax prevention
Prevention: Actively carry out health publicity and education, strengthen physical exercise, enhance physical fitness, and improve disease resistance. Prevent respiratory infections. Active treatment of the primary disease. Stay optimistic and happy. Long-term mental stress, anxiety, irritability, pessimism and other emotions will make the balance of the cerebral cortex excitatory and inhibition process imbalance, so you need to maintain a happy mood.
Complication
Closed pneumothorax complications Complications rib fractures
Closed pneumothorax is a complication of rib fracture. The rib fracture breaks the lung surface and air leaks into the pleural cavity.
Symptom
Closed pneumothorax symptoms Common symptoms Shortness of breath, chest tightness, chest pain, breath sounds, weakened pneumothorax
The clinical symptoms of pneumothorax depend on the amount of pleural effusion and the speed of occurrence. A small amount of pneumothorax collapses below 30%, which has little effect on respiratory and circulatory function, and has no obvious symptoms. When the lung is compressed more than 50%, it is a large number of pneumothorax. Restrictive ventilatory dysfunction may occur, the patient has symptoms such as chest tightness, shortness of breath and chest pain, and the percussion of the injured chest is drum sound, and the auscultation breath sound is weakened or disappeared.
Examine
Closed pneumothorax examination
X-ray examination can show varying degrees of lung atrophy and pleural effusion, sometimes accompanied by a small amount of pleural effusion.
The patient has no significant respiratory and circulatory dysfunction. Moderate pneumothorax collapse in 30% to 50%, and a large number of pneumothorax lung collapse in more than 50%, can appear chest tightness, shortness of breath and other hypoxemia performance. X-ray chest X-ray is an important means to diagnose closed pneumothorax, but a small amount of pneumothorax, especially the injury is not allowed to stand up, the former film is easy to be missed. Thoracentesis can help with diagnosis.
Diagnosis
Closed pneumothorax diagnosis
Lung collapsed below 30%, affecting respiratory and circulatory function, and no obvious symptoms. A large number of pneumothorax, the patient developed chest tightness, chest pain and shortness of breath, the trachea was shifted to the healthy side, the percussion of the injured side of the chest was drum sound, and the auscultation breath sounds weakened or disappeared. Patients with poor lung function and the elderly, as well as those with other serious injuries, such as severe head injury and severe shock, should have a positive attitude toward the treatment of closed pneumothorax. During treatment, the vigilance develops into a tension pneumothorax.
