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难治性自发性气胸系指经内科常规治疗两周以上而无手术条件的自发性气胸。我们治愈1例报道如下。 患者男,49岁,患矽肺结核7年,因胸闷,气喘于1985年4月23日入院。查体:T37℃,神清,端坐位,气促,唇轻度发绀,而肺呼吸音低,并闻及散在湿罗音,心音低,心率114次,P_2>A_2。心电图:窦速,肺型P波,右室肥大。胸片:两上中大片结节融合团块,肺门上提,肺纹呈垂柳状,两下多发肺大泡,胸膜增厚,心脏呈滴状。血:WBC8.2×10~9/L,N61％,L39％。临床诊断:Ⅲ期矽肺合并结核,肺大泡,慢性肺心病,继发感染,慢性呼衰与心衰。给抗结核,抗感染及对症治疗,症状好转。7月12日突然气急。胸片示:左下气胸,肺压缩50％。抽气1600ml后于左第4前肋间腋前线胸腔插管,先正压引流,有持续不断的大量气泡由水封管逸出,后持续低
Refractory spontaneous pneumothorax refers to the routine internal medical treatment of more than two weeks without surgical conditions of spontaneous pneumothorax. We are cured of a reported as follows. Male patient, 49 years old, suffering from silicosis tuberculosis for 7 years, due to chest tightness, panting admitted on April 23, 1985. Physical examination: T37 ℃, Shen Qing, sitting, shortness of breath, lips mild cyanosis, and lung breath sounds low, and smell and scattered in the wet rales, low heart sounds, heart rate 114 times, P_2> A_2. Electrocardiogram: sinus speed, pulmonary P wave, right ventricular hypertrophy. Chest X-ray: two large nodules in the fusion mass, hilar on the lung pattern was weeping willow-like, multiple lung bullae two times, pleural thickening, the heart was drop-shaped. Blood: WBC 8.2 × 10 ~ 9 / L, N61%, L39%. Clinical diagnosis: Ⅲ silicosis with tuberculosis, bullae, chronic pulmonary heart disease, secondary infection, chronic respiratory failure and heart failure. To anti-TB, anti-infective and symptomatic treatment, the symptoms improved. July 12 sudden shortness of breath. Chest X-ray showed: lower left pneumothorax, lung compression 50%. After aspiration of 1600ml in the left front of the fourth intercostal axillary chest intubation, positive pressure drainage, there are a large number of continuous bubbles escape from the water seal tube, continued low after