A. Causes 1, traumatic pneumothorax: a variety of common chest trauma, including sharp-edged stab wounds and gunshot penetrating wounds rib fracture end misalignment stab wounds lung, as well as lung injury during diagnostic and therapeutic medical operations, such as acupuncture puncture lung biopsy, artificial pneumothorax, etc. 2, secondary pneumothorax: for bronchopulmonary disorders broken into the chest cavity to form a pneumothorax. Such as chronic bronchitis, pneumoconiosis bronchial asthma caused by obstructive pulmonary disorders, pulmonary interstitial fibrosis, cellular lung and bronchopulmonary cancer partially occluded airways produced by vesicular emphysema and pulmonary alveoli, as well as septic pneumonia near the pleura, lung abscess tuberculous cavity, pulmonary fungal disease, congenital pulmonary cysts, etc. 3, idiopathic pneumothorax: refers to the usual history of no respiratory disease, but there can be subpleural alveoli, once the rupture formed pneumothorax is called idiopathic pneumothorax mostly seen in lean and long body type of male young adults. 4, chronic pneumothorax: refers to the pneumothorax after 2 months is not yet fully reopened. The reasons for this are: difficult to absorb the encapsulated liquid pneumothorax, not easy to heal the bronchial negotiation pleural fistula alveoli or congenital bronchial cysts formed by the pneumothorax, as well as the airway obstruction or atrophy of the lung connected with the pneumothorax covered with a thicker mechanized envelope to prevent lung reopening. Clinical manifestations Patients often have triggering factors such as holding heavy objects, breath-holding, strenuous exercise, etc., but there are also cases of pneumothorax occurring during sleep, where the patient suddenly feels chest pain, shortness of breath, breath-holding, coughing, but little sputum, and a small amount of closed pneumothorax with shortness of breath first, but gradually stabilizes after a few hours, and X-ray does not necessarily show lung compression. If the pneumothorax is large or if there is an existing extensive lung disease, the patient often cannot lie down. If the patient lies on his or her side, he or she is forced to put the affected side of the pneumothorax on top to reduce shortness of breath. The degree of dyspnea is related to the amount of pneumoperitoneum and the extent of the original intrapulmonary lesion. When there are pleural adhesions and pulmonary function impairment, even a small amount of limited pneumothorax may cause significant chest pain and shortness of breath. The initial diagnosis can be made when there is sudden onset of chest pain on one side with dyspnea and pneumothorax signs, and the diagnosis is confirmed by X-ray showing pneumothorax signs. When pneumothorax is complicated by severe asthma or emphysema, symptoms such as shortness of breath and chest tightness are sometimes not easily detected, and should be carefully compared with the original symptoms. Patients may or may not have a trigger to increase the pressure in the chest and skin cavity before the onset of pneumothorax, and the main symptoms are dyspnea, chest pain, irritating dry cough, and severe irritability, cyanosis, sweating and even shock in tension pneumothorax. Treatment The principle of treatment is to properly ventilate according to the different types of pneumothorax, in order to release the obstacle generated by the pneumothorax on breathing and circulation, so that the lung can be reopened as soon as possible and restore the function, and also to treat the complications and primary diseases. 1, symptomatic treatment: bed rest should be given, oxygen, analgesia, cough, antibiotic treatment when there is infection. 2, thoracic decompression: (1) closed pneumothorax, lung compression <20%, simple bed rest leisure pneumothorax can be self-absorption, lung compression >20% symptoms should be thoracentesis pumping 1/1 ~ 2d times, each time 600 ~ 800ml is appropriate. (2) open pneumothorax, the application of closed chest drainage exhaust, the lung still can not be reopened, can be added with negative pressure continuous suction. (3) Tension pneumothorax, the condition is more critical must be exhausted as soon as possible to reduce pressure, while preparing to immediately perform closed chest drainage or negative pressure continuous suction. 3.Surgical treatment: For patients whose lungs cannot be reopened by active medical treatment, chronic pneumothorax or bronchopleural fistula can be considered for surgical treatment, and we often recommend surgical treatment for patients with the first attack of pneumothorax. At present, thoracoscopic pneumonectomy is generally performed, and recurrent pneumothorax can be treated by pleural fixation. Surgery has the advantages of less trauma and faster recovery (patients can usually be discharged in a week or so after surgery).