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1 临床资料患者男性,22岁,初教-6飞行学员,飞行总时间42 h。平素身体健康,积极参加各项体育锻炼,飞行耐力强,适应空中生活。2005年初某日以“脖子扭了”主诉就医。查体:仅在颈部左偏时疼痛,无异常体征,也无其它不适症状,未作特殊处理。次日又来就诊,主诉深呼吸时右侧胸部不适,无明显胸闷、咳嗽、咳痰等症状。触诊发现右侧颈部有巴掌大小握雪感,听诊捻发音明显,心前区可听到与心跳一致的吡啪音(Hamman 征)。怀疑“皮下气肿”,送本地医院会诊。胸片示:纵隔两侧边缘可见与其平行的条索阴影,右侧颈部皮下软组织内少量条索、斑点状透光阴影。诊断:①自发性纵隔
1 Clinical data Male patients, aged 22, early-6 flight students, the total flight time 42 h. Normal physical health, and actively participate in various physical exercises, flight endurance and adapt to the air life. One day in early 2005 to “neck twisted” chief complaint for medical treatment. Physical examination: Only when left neck pain, no abnormal signs, no other symptoms, no special treatment. The next day again for treatment, the main complaint when the chest deep right chest discomfort, no obvious chest tightness, cough, sputum and other symptoms. The palpation revealed palpitation of snow on the right side of the neck, pronounced auscultation of the pronunciations, and Hammer signs consistent with the heartbeat in the precordial area. Suspected “subcutaneous emphysema,” sent to the local hospital consultation. Chest X-ray showed: the edges of the mediastinum can be seen parallel to the bar shadow, the right side of the neck subcutaneous soft tissue a small amount of bar, spot-like translucent shadow. Diagnosis: ① spontaneous mediastinal