患者,女,18岁,因“突发呼吸困难13h于2001年1月10日入我科。患者13h前无明显诱因下突发呼吸困难,有喘憋感,伴口唇发绀、出汗、讲话困难,无咳嗽、咳痰及咯血,无发热。至我院急诊室拟”哮喘“予吸氧,使用氨茶碱(静注0.25g加静滴0.5g)、地塞米松(共20mg),吸入普米克气雾剂(共4OOμg×4),病情无改善,胸闷加剧,渐出现面部及颈部增粗,摄胸片示纵隔及面颈、皮下气肿。行经胸骨上窝切开上纵隔 Patient, female, 18 years old, due to ”sudden breathing difficulties 13h into my department January 10, 2001. Patients 13h before no obvious incentive for sudden breathing difficulties, wheezing, accompanied by lips cyanosis, sweating, Difficult to speak, no cough, sputum and hemoptysis, no fever to our hospital emergency room to be “asthma ” to oxygen, using aminophylline (intravenous 0.25g plus intravenous infusion 0.5g), dexamethasone 20mg), inhalation of Pulmicort aerosol (a total of 4OOμg × 4), no improvement in condition, increased chest tightness, gradually appear thickening of the face and neck, chest X-ray showed mediastinal and face neck, subcutaneous emphysema. Open the mediastinum