泰主sp - T1的动态管理ontaneous pneumothorax: the good is (not always) the enemy of the better (evidence) JF - European Respiratory Journal JO - Eur Respir J SP - 334 LP - 336 DO - 10.1183/09031936.00161813 VL - 43 IS - 2 AU - Valipour, Arschang Y1 - 2014/02/01 UR - //www.qdcxjkg.com/content/43/2/334.abstract N2 - Pneumothorax is defined as the presence of air in the pleural cavity. A pneumothorax might occur spontaneously in patients without underlying lung disease (primary spontaneous pneumothorax (PSP)) or in patients with an underlying lung disease (secondary spontaneous pneumothorax), most commonly chronic obstructive pulmonary disease. The underlying cause of spontaneous pneumothorax is likely to be the rupture of “emphysema-like changes” (small bullae or blebs) on the pleural surface, which allows air from the lung into the pleural space. Smoking, male sex and height are the major risk factors for the development of a PSP. There is evidence of a pleural inflammatory reaction in patients with PSP, involving an increase in eosinophils and neutrophils as well as elevated inflammatory cytokines compared with blood levels [1].From an epidemiological point of view, PSP remains a significant health problem, with an annual incidence of 18–28 per 100 000 in males and 1.2–6.0 per 100 000 in females [2, 3]. Primary therapeutic goals for PSP include removal of air from the pleural space and prevention of recurrences. Air evacuation may be achieved by simple manual needle aspiration, by a small bore tube or a conventional chest tube, the tubes being attached to a one-way valve or to a water-seal device, with or without active suctioning [4].The treatment of PSP would lend itself well to ambulatory management, since patients are usually young, without relevant comorbidities, and the condition itself caries a low morbidity and mortality [5]. Furthermore, outpatient-orientated treatment rather than hospitalisation might be favoured by many patients and would substantially reduce health-cost expenses. Unfortunately, however, the adherence to recommendations of outpatient management of patients with PSP in clinical practice is rather low [5, 6]. The lack … ER -