What are the main causes of spontaneous pneumothorax?

Causes of Pneumothorax

Tracheitis, chronic bronchitis complicated by emphysema, bronchial asthma, pneumoconiosis, extensive pulmonary fibrosis, bullous rupture, etc. Lung cancer, tuberculosis cavities, and lung abscesses can also cause pneumothorax. For the elderly, the primary disease is chronic obstructive pulmonary emphysema in most cases, and the triggering factors are mostly infection, severe cough and asthma.

How to judge the occurrence of pneumothorax

Chest pain Most patients have varying degrees of chest pain, which is caused by pleural adhesion, traction and tearing. Chest pain may occur suddenly and may be stabbing or distending, and the pain may worsen with coughing or deep breathing. However, due to the slow perception of the elderly, the symptoms of chest pain are often not as obvious as those of young people. Therefore, early diagnosis is easily delayed.

Dyspnea often occurs at the same time as chest pain. In young people, if lung compression is less than 20%, dyspnea may not be obvious. However, since most elderly people have chronic lung diseases and poor lung function, they may experience obvious breathing difficulties even if the lung compression is only 10%. If it is a high-pressure pneumothorax, the patient may experience progressive dyspnea, or even shock, respiratory failure, etc.

Cough is mostly dry cough, caused by pleural reflex stimulation. If there is infection or bronchopleural fistula, the cough will worsen and produce purulent sputum.

If high-pressure pneumothorax is not treated promptly, the patient may go into shock. In addition to difficulty breathing, the patient may also experience cyanosis, profuse sweating, irritability, confusion, cold limbs, weakened pulse, low blood pressure, and even death.

The signs of spontaneous pneumothorax in the elderly are easily masked by the primary disease (such as chronic bronchitis combined with obstructive pulmonary emphysema), resulting in delayed diagnosis. At this time, X-ray examination can help confirm the diagnosis and understand the degree of lung compression. At the same time, pay attention to the tracheal deviation, which often provides useful hints.

How to treat spontaneous pneumothorax

The first priority is to expel the gas, reopen the lungs, and restore respiratory function. At the same time, pay attention to the prevention and treatment of complications, such as pneumothorax, hemothorax, etc. Whether to deflate or not should be determined based on comprehensive considerations such as the patient's lung compression level, the nature and extent of the primary disease, and the type of pneumothorax. Patients with critical conditions require emergency simple ventilation. For those whose breathing difficulties cannot be relieved by repeated vacuuming, closed drainage and ventilation can be used.

Elderly people with chronic lung diseases, especially those with emphysema and bullae, if their cough and dyspnea suddenly worsen, or if dyspnea does not improve after treatment of the primary disease, they should consider whether spontaneous pneumothorax has occurred and should go to the hospital for examination and treatment as soon as possible.