急性狼疮性肺炎继发气胸一例并文献复习

发布时间：2018-06-24 20:16

本文选题：系统性红斑狼疮 + 狼疮性肺炎　；参考：《中国呼吸与危重监护杂志》2017年06期

【摘要】：目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)继发气胸的临床特征,增加对其的认识。方法对1例SLE患者发生急性狼疮性肺炎继发气胸的发病过程、临床表现、胸部影像学特点及诊治经过进行分析。以"systemic lupus erythematosus"和"pneumothorax"为检索词在PubMed数据库进行检索,以"狼疮"和"气胸"为检索词在万方数据库和中国知网数据库中进行检索,检索时间为1971~2016年,复习相关文献。结果患者,女,26岁,因反复发热3个月,胸闷、气促10 d于2016年12月就诊。诊断为急性狼疮性肺炎。入院后接受糖皮质激素、环磷酰胺及血浆置换等治疗。住院期间患者突发右侧胸痛,胸部CT检查提示右侧气胸,经胸腔闭式引流后好转。检索文献报道14例,其中2例因数据不全被剔除。余下的12例中女9例,男3例。平均年龄(28.0±11.9)岁。其临床表现多为突发胸闷、气促,常伴有胸膜下肺空洞、囊腔状改变。大部分患者经胸腔闭式引流后气胸消失,少数需接受胸腔镜手术。结论 SLE继发气胸罕见,常与SLE继发肺空洞、囊腔破裂有关,大部分患者经胸腔闭式引流术后气胸可治愈。
[Abstract]:Objective to explore the clinical characteristics of systemic lupus erythematosus (SLE) secondary pneumothorax, and to increase the understanding of it. Methods the pathogenesis, clinical manifestation, chest imaging characteristics and diagnosis and treatment of 1 cases of SLE patients with acute lupus pneumonia secondary pneumothorax were analyzed. "Systemic lupus erythematosus" and "PN". Eumothorax "retrieves the retrieval words in the PubMed database, using the" lupus "and" pneumothorax "as the retrieval word in the Wanfang database and the Chinese knowledge network database. The retrieval time is 1971~2016 years, and the related literature is reviewed. The results of the patients, women, 26 years old, for 3 months of fever, chest tightness, and 10 d in December 2016. Sore pneumonia. Treated with corticosteroids, cyclophosphamide and plasma exchange after admission. Patients who had sudden right chest pain during hospitalization, chest CT examination prompted right pneumothorax and closed thoracic drainage. 14 cases were reported, of which 2 cases were excluded because of data incompetence. The remaining 12 cases were 9 cases, male 3 cases (28 + 11.9). The clinical manifestations of the patients are sudden chest tightness and shortness of breath, often accompanied by the disappearance of the pneumothorax after closed thoracic drainage and a few patients undergoing thoracoscopic surgery. Conclusion SLE secondary pneumothorax is rare, which is often associated with SLE secondary pulmonary cavity, the rupture of the capsule cavity, and most patients after closed thoracic drainage of pneumothorax. Cure.
【作者单位】：南京医科大学第一附属医院呼吸与危重症医学科;皖南医学院弋矶山医院呼吸内科;南京医科大学第一附属医院风湿免疫科;
【分类号】：R593.243

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