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患者男性,68岁。因突然胸痛、进行性呼吸困难1d余入院。患者于1年前因左肺舌叶腺癌,纵膈淋巴结转移行放疗两个疗程。体检:T37.6℃P104次/min,R28次/min,BP15/8kPa。端坐呼吸。口唇紫绀。颈静脉充盈。右胸廓饱满,叩诊鼓音,呼吸音明显减弱,左肺呼吸音粗,无罗音。胸部透视:右肺压缩60％,纵隔向左移位,左肺中野见点片状及条索状阴影。诊断为右侧自发性气胸,左肺纤维化。即刻在无菌操作下行注射器胸内抽气术,抽气过程中患者感觉呼吸困难减轻,共抽气约800ml。
Male patient, 68 years old. Due to a sudden chest pain, progressive dyspnea more than 1d admission. Patients in the left lung lobular adenocarcinoma 1 year ago, mediastinal lymph node metastasis of two courses of radiotherapy. Physical examination: T37.6 ℃ P104 times / min, R28 times / min, BP15 / 8kPa. Sit and breathe The lips are cyanotic. Jugular vein filling. Right thorax full, percussion drum sound, breath sounds significantly weakened, left lung breath sounds rough, no rales. Chest perspective: Right lung compression 60%, shift to the left mediastinum, the left lung midfielder see flake and bar-like shadow. Diagnosis of the right spontaneous pneumothorax, left pulmonary fibrosis. Immediately in the sterile syringe down the chest thoracotomy, patients feel less difficulty breathing during aspiration, a total of about 800ml suction.