原發自發性氣胸：診斷與治療之文獻回顧，現況與展望

Primary Spontaneous Pneumothorax. Literature Review, Present Status and Future Perspectives

李華鎮(Hwa-Chan Lee) ； 黃英傑(Ying C. Huang) ； 陸希平(Shi-Ping Luh)

《中華民國急救加護醫學會雜誌》 21卷S期 (2010/12) Pp. 9-20

https://doi.org/10.30018/JECCM.201012.0015

摘要

原發自發性氣胸常見於年輕瘦高的男性，其成因有許多說法。在病生理機轉上，多導因於肺部肋膜表面的氣泡破裂所致。在診斷及處置上，可使用保守或外科治療等多種方式。由於胸腔內視鏡微創手術的發展，對於復發或頑固難治個案，或是在影像上可見明顯氣泡的情況，可以考慮使用內視鏡手術處理氣泡及肋膜的問題。而電腦斷層對於氣胸同側及對側氣泡存在與位置的評估，局部沾黏的嚴重性等提供許多在臨床治療計畫及決策上的重要資訊。

關鍵字

自發性氣胸 ； 氣泡 ； 胸腔內視鏡微創手術 ； 電腦斷層

並列摘要

Primary spontaneous pneumothorax mostly occurs in tall and thin young male. Rupture of bullae or blebs on the visceral pleural surface is regarded to result in pneumothorax in this patient. Primary spontaneous pneumothorax can be managed by conservative or surgical methods. The development of video-assisted thoracoscopic surgery (VATS) made this procedure as one of important treatment options for this patient. VATS treatment is indicated for recurrent cases, those who are refractory to conservative treatments or visible bullae/blebs on image findings. Chest computed tomography can be used to assess the existence and location of bullae/blebs on the ipsilateral or contralateral side, as well as the severity of pleural adhesion. These above information is important to determinate subsequent decision and plan of management.

並列關鍵字

spontaneous pneumothorax ； bullae/blebs ； video-assisted thoracoscopic surgery ； computed tomography