What is open pneumothorax explained by experts?
summary
After suffering from pneumothorax, the best way to avoid pneumothorax is to do a good job in the prevention of pneumothorax and avoid pneumothorax in advance. Pneumothorax in the treatment, is also very troublesome, pneumothorax for a long time, people should pay attention to a lot of matters, to avoid the trouble caused by pneumothorax. So do you know what is open pneumothorax? Now let's take a look at it.
What is open pneumothorax explained by experts?
First, because of the adhesion and traction between the two layers of pleura, the break continues to open. When breathing in and out, the air flows in and out of the pleural cavity freely. The pressure in the pleural cavity of the affected side was about 0, and the pressure did not decrease after several minutes of observation. Patients with open pneumothorax often have severe dyspnea, panic, weak pulse frequency, cyanosis and shock after injury. During the examination, there was an obvious wound in the chest wall leading into the chest, and the "hiss hiss" sound of air in and out with breathing could be heard. Percussion on the injured side showed that the tympanic sound disappeared, and sometimes the mediastinal swing sound could be heard.
Second, in patients with small volume of gas and no obvious dyspnea, after bed rest and limited activities, or installation of water sealed bottle drainage, sometimes the pleural break may be self closed and turn into closed pneumothorax. If dyspnea is obvious, or COPD patients with pulmonary insufficiency can try negative pressure suction, in the process of lung recruitment, the break will also be closed, if the break is large, or because of pleural adhesion and continuous opening, the patient's symptoms are obvious, simple exhaust measures can not work, through thoracoscopic observation, adhesion cauterization, promote the break to close. If there is no contraindication, thoracotomy can also be considered to repair the breach. Wiping the parietal pleura with gauze during operation can promote postoperative pleural adhesion. Lobectomy or segmental resection of the involved lung may be considered if there are obvious lesions in the lung.
Third, clinical manifestations; Patients with open pneumothorax often have severe dyspnea, restlessness, weak pulse frequency, cyanosis and shock after injury. During the examination, there was an obvious wound in the chest wall leading into the chest, and the "hiss hiss" sound of air in and out with breathing could be heard. Percussion on the injured side showed that the tympanic sound disappeared, and sometimes the mediastinal swing sound could be heard.
matters needing attention
Finally, open pneumothorax is easy to diagnose, once found, emergency treatment must be given immediately. According to the site conditions of the patients at that time, self rescue or mutual rescue should be carried out to close the chest wall wound as soon as possible, so as to change the open pneumothorax into closed pneumothorax. Large first aid kit, multi-layer cleaning cloth or thick gauze pad can be used. If there are large pieces of sarin gauze or sterile plastic cloth, it is more suitable. The sealing dressing should be thick enough to avoid air leakage, but it should not be filled into the wound; The range should be more than 5cm above the wound edge. After arriving at the hospital, the patients were given blood transfusion, rehydration and oxygen inhalation to correct the respiratory and circulatory dysfunction, and further check and clarify the injury. After the general condition was improved, debridement was performed under tracheal intubation anesthesia and closed thoracic drainage was placed as soon as possible. If there is serious injury of lung, bronchus, heart and blood vessel, thoracotomy should be done as soon as possible.
