When diagnosing and differentiating pneumothorax from giant pneumothorax, chest puncture should be done with caution. In the beginning, if pneumothorax is mistaken for pneumothorax and thoracentesis is performed, it may lead to pneumothorax of medical origin and even become tension pneumothorax. If no distinction can be made between pulmonary herpes or tension pneumothorax and the patient is in high respiratory distress, temporary puncture or drainage and decompression may be recommended in emergency situations to save life, but at the same time, preparations for further thoracotomy should be made. Spontaneous pneumothorax is the most common complication of pneumothorax, followed by infection and spontaneous hemopneumothorax. Spontaneous pneumothorax can be asymptomatic. When the pressure suddenly increases during sudden exertion, such as violent coughing, heavy lifting or sports, the pulmonary blister ruptures and gas enters the pleural cavity from the lung, forming spontaneous pneumothorax, dyspnea, shortness of breath, shortness of breath, panic and rapid pulse may occur. The degree of atrophy depends on the amount of gas entering the chest cavity and the pathology of the original lesions of the lung and pleura. If the patient has emphysema, pulmonary fibrosis, long-term chronic infection of lung tissue, etc. in addition to pulmonary blister, although some of the gas enters the chest cavity when the pulmonary blister ruptures, and the degree of lung tissue atrophy can be lighter, the symptoms are heavier because the patient’s original lung function has decreased. The pneumothorax line formed by the compressed lung is visible on X-ray, and if adhesions are present, the pneumothorax line is irregular. After the rupture of pulmonary macula, a small part of the fissure is small and the fissure closes by itself after the lung tissue atrophy, the air leakage stops, the pneumothorax is gradually absorbed, the negative chest pressure is restored and the lung reopening is healed. Tension pneumothorax, if the lung blister ruptures and forms a live valve, the negative pressure in the chest cavity increases when inhaling, the gas enters the chest cavity, and the live valve closes when exhaling, the gas cannot be discharged, especially when coughing, the airway pressure increases when the vocal valve closes, the gas enters the chest cavity, the vocal valve opens, the airway pressure decreases, the fissure closes again, and the amount of gas in the chest cavity increases with each breath and cough, forming tension pneumothorax. In tension pneumothorax, the lung tissue on the affected side is completely atrophied and the mediastinum is pushed to the healthy side, while the lung tissue on the healthy side is also compressed and the large blood vessels of the heart are displaced and the large veins are distorted and deformed, which affects the blood return and causes serious obstruction to the respiratory circulation. The affected side of the thorax is elevated, mostly accompanied by subcutaneous emphysema on the affected side, and the trachea is obviously displaced to the healthy side, which is critical and often requires emergency treatment. Spontaneous hemothorax caused by pulmonary maculae, most of them bleed from adhesions and adhesive tears of the pulmonary tissue around the apical maculae or maculae with the apex of the chest activity. The small arteries in the adhesion zone can be up to 0.2 cm in diameter, and the vessels originate from the body circulation with high pressure, while the thoracic cavity is under negative pressure, which increases the tendency of bleeding. In addition, the bleeding is difficult to stop automatically because the blood in the thoracic cavity does not coagulate due to the defibrotic effect of lung, heart and diaphragm movements. Clinical symptoms may vary depending on the speed of bleeding. When bleeding is slow, patients may present with gradually increasing chest tightness, dyspnea, blunted diaphragm angle visible on X-ray, or parabolic images of pleural effusion. When bleeding is rapid, shock can be manifested within a short period of time. When the adhesions between the pulmonary blister and surrounding lung tissue and chest wall are torn, spontaneous hemopneumothorax is formed if there is a rupture of blood vessels in the adhesion zone and the lung tissue is damaged at the same time. In recent years, some scholars point out that the amplitude of diaphragm activity may play a decisive role in the occurrence of spontaneous hemopneumothorax, and that the amplitude of diaphragm activity increases during strenuous activities such as rejection of air and force, resulting in a sudden direct or indirect pull on the adhesive band at the top of the chest. If the tear is on the wall side or central section of the cord, only a hemothorax will occur. The diaphragm is more active in long and lean young people and relies more on abdominal breathing because the pectoral muscles are less developed. Women are predominantly thoracic breathers and have a lower incidence. The right lung is triple-lobed and its lobe space plays a buffering role against the violent downward pull, and there is still a liver under the right lung, which may be the reason why the right side has less morbidity. Therefore, patients with spontaneous hemopneumothorax are characterized by young age, more males than females, more left side than right side, and more long and lean body type. Bilateral spontaneous pneumothorax also occurs from time to time, mostly on the left side first and on the right side later, and in individual cases, it occurs bilaterally at the same time, which is critical and even life-threatening. Secondary infection of pulmonary blisters In most cases, pulmonary blisters occur at the distal end of the bronchus above the eighth grade, and most of them are not infected, but if the draining bronchus is blocked and the bronchus of pulmonary blisters is filled with inflammatory secretions, the patient may have fever, cough, sputum and other symptoms of infection, and sometimes the clinical symptoms improve after anti-infection treatment, but the signs of infection on chest X-ray can still last for a longer period of time.