Pneumothorax patients are also admitted to respiratory medicine and treated by thoracic surgery. Some of them only need to be hospitalized for dynamic observation, some need to be punctured and pumped, some need to be punctured and drained by a thin tube in internal medicine, some need to be surgically drained by a thick tube in surgery, some need to be operated with an incision of more than 30 cm, and some choose thoracoscopic surgery. Some patients recover quickly, some recover slowly, and some have life-threatening conditions. Some have multiple recurrences, while others are cured at once. Should I stay in thoracic surgery or respiratory medicine if I have pneumothorax? Which treatment should I choose? Because medical doctors can treat pneumothorax in the same way as thoracic surgeons, it is not necessary to operate in surgery, but once the conservative treatment of pneumothorax is ineffective, surgical intervention is needed, so in order to be able to operate in time when surgery is needed, in order to get the optimal treatment plan at the early stage of treatment, instead of looking for a surgeon when all methods are exhausted and ineffective, and in order to shorten the hospitalization time and hospitalization cost In order to reduce the length of stay and hospitalization costs, it is more beneficial for patients with pneumothorax to stay in thoracic surgery. However, it is only natural and in accordance with medical principles that pneumothorax should be treated in respiratory medicine. Since the most common spontaneous pneumothorax is first diagnosed in internal medicine, the most common procedure is conservative treatment in internal medicine first, and if the conservative treatment is not effective, the patient is referred to thoracic surgery, which is a commonly accepted treatment procedure. However, in case of recurrent pneumothorax, tension pneumothorax, combined fluid pneumothorax or pneumothorax with large pulmonary alveoli found on imaging, it is recommended to stay in thoracic surgery directly. Etiology of pneumothorax Pneumothorax can be divided into two major categories: 1. Spontaneous pneumothorax: most of them are produced by alveolar rupture, which occurs in adolescents and smokers. This is followed by pneumothorax caused by various diseases, such as inflammation of the lung, tuberculosis, tumor and chronic obstructive emphysema. 2.Acquired pneumothorax: It is commonly caused by trauma, post-surgery, various punctures and the use of ventilators. Symptoms of pneumothorax: sudden onset of chest pain, dyspnea and cough. A small number of patients have no obvious symptoms and only show shortness of breath or chest tightness after activity. How to diagnose pneumothorax The diagnosis of pneumothorax is very simple, which can be confirmed by X-ray fluoroscopy, X-ray chest film or chest CT. Treatment of pneumothorax 1. Observation, bed rest and oxygen: Pneumothorax with less than 30% lung compression can be observed for a short period of time, and the treatment plan should be changed in time if the condition does not improve during the observation period. If CT finds obvious alveoli, thoracoscopic alveolar resection is also a good choice in order to treat thoroughly and prevent recurrence. Elderly patients, combined with severe emphysema patients with poor lung function compensatory capacity, lung compression of 10% or less may have severe respiratory distress, can not just observe conservative treatment, should be timely puncture exhaust. 2.Thoracocentesis pumping: Pneumothorax with lung compression greater than 30% is promptly punctured and pumped or the following more aggressive treatment methods. Thoracentesis suction is simple and easy to perform, but the efficacy is poor, often requiring multiple punctures and prone to recurrence. It can be combined with injection of tetracycline and talcum powder to promote pleural adhesions to improve the efficacy. 3.Puncture and fine tube drainage: usually use deep vein catheter, which is simple to operate and can be mastered by internal medicine doctors. Because of the fine diameter and soft tube, the patient’s comfort is high. But the efficacy is poor, easy to block the tube, not suitable for tension pneumothorax, and the recurrence rate is high. 4.Closed chest drainage: standard closed chest drainage can only be done by surgeons, with thick tube drainage and good drainage effect. The disadvantage is that the cause is not removed, and the recurrence rate is higher. 5.Open-chest surgery: Anyone who encounters the following cases should consider surgery: those with occupational hazards, such as pilots, divers, those engaged in long-term sea or field operations; recurrent pneumothorax; those whose lungs are still not reopened by closed chest drainage or those who still leak air after 3 days of drainage. 6.Thoracoscopic surgery: a new technology introduced to China in 1992. Due to the small injury, fast recovery, reliable efficacy and low recurrence rate, it has replaced open-heart surgery as the most effective treatment method for pneumothorax. Due to the simple and minimally invasive surgery, it can also replace several other conservative treatment methods and perform thoracoscopic surgery directly. After long-term observation: 30% of the first time spontaneous pneumothorax patients will recur within 2 years, 39% of the cases that need closed chest drainage to improve the first attack can recur again, and 80% of the patients who improve the second attack by closed chest drainage will have the third attack, so the early implementation of thoracoscopic surgery is the wisest choice. Preventive care for pneumothorax patients: Absolute smoking ban and avoid second-hand smoke. Do more chest-expanding exercises and deep-breathing movements in normal times. Avoid cold and flu and timely treatment of respiratory tract infections.