Uncle Song, 65, who has a history of COPD for many years, has experienced cough, sputum cough, shortness of breath and other symptoms in recent days because of a cold, and went to the acupuncture physiotherapy room of the community for acupuncture treatment. After a few injections, instead of relieving the symptoms, Uncle Song showed obvious shortness of breath, aggravated breathing difficulties, and almost lost his life, and was urgently sent to the Respiratory and Critical Care Medicine Department of the Second People's Hospital of Hunan Province for treatment by his family.
After the diagnosis led by Director Zeng Xiangbo, it was determined that Uncle Song was a tension pneumothorax, and the pleural drainage tube was immediately placed to discharge the gas and reduce the pressure in the pleural cavity.
"Emphysema patients due to increased lung volume, alveolar tone increased, acupuncture is prone to pneumothorax, need to cooperate with special acupuncture techniques", Zeng Xiangbo said, emphysema patients due to treatment need acupuncture treatment, should go to the regular medical institutions, and the operator should be familiar with the anatomy enough, according to the local anatomical characteristics of acupuncture points and the patient's fat and thin to choose the appropriate length of needles, acupuncture direction to oblique prick or flat prick is appropriate, prohibit direct pricking and deep prick, avoid needle selection is too long, too thick, avoid acupuncture too deep, angle is too straight 3. The technique is too heavy. Once a patient with tension pneumothorax develops a serious and critical condition, emergency treatment must be carried out urgently.
What is tension pneumothorax?
Zeng Xiangbo explained that tension pneumothorax is an emergency that belongs to the pneumothorax, also known as hyperbaric pneumothorax, which refers to the one-way live valve of the air leakage channel of the pleural cavity, and the pressure in the pleural cavity decreases each time the inhalation is reduced, the live valve is opened, and the gas enters; the pressure in the pleural cavity rises when exhaling, the live valve is closed, and the gas cannot be discharged; the gas enters the pleural cavity and accumulates, resulting in the pressure of the pleural space is increasing, and finally higher than the atmospheric pressure, so that the lungs are compressed, and the diaphragm is displaced to the healthy side, affecting normal breathing and blood circulation.
What are the clinical manifestations of tension pneumothorax?
After the development of tension pneumothorax, it is manifested as extreme dyspnea and sit-down breathing. Severe hypoxia presents with cyanosis, irritability, coma, and even suffocation. On physical examination, the chest is full, the intercostal space is widened, the breathing amplitude is reduced, and there may be subcutaneous emphysema on the injured side. Percussion is a drum sound. Breath sounds disappear on auscultation. Chest x-ray shows a large amount of gas accumulation in the pleural space, the lungs can be completely collapsed, and the trachea and heart shadow are shifted to the healthy side. Puncture of the pleural cavity involves a high-pressure gas rushing outward. After exhaustion, symptoms improve and can soon worsen.
How can it be prevented?
Zeng Xiangbo reminded that to prevent repeated pneumothorax attacks in life, it is necessary to avoid strenuous exercise, coughing, lifting weights or lifting the upper arm, lifting weights, exerting force to relieve stools and other actions; maintain good eating habits; pay attention to keep warm, keep the air clean, and prevent upper respiratory tract infections; pneumothorax without surgery, and avoid activities such as flying, diving, and diving within half a year.
Physical discomfort must go to regular medical institutions for diagnosis and treatment, and the "rhetoric" and so-called "folk remedies" of non-medical personnel cannot be trusted.
Contributed by: Huang Rui, Department of Respiratory and Critical Care Medicine, Second People's Hospital of Hunan Province
Editor: Liu Yuchen
Image: From the Internet, intrusion and deletion