Chapter 2299 【2299】Meaning
On the X-ray film, the lung field on one side is divided into three bands: outer, middle and inner from the periphery to the hilum.
Under normal circumstances, there are lung markings in the lungs, which account for up to 90% of the lung area, which can be said to basically represent the lungs. Lung markings are the projections of blood vessels, lymphatic vessels, bronchi, etc. of the lungs under the X-ray machine. We know from anatomy that these structures of the lungs are like the branches of a big tree, with lines and branches interlaced. The scene presented in imaging is also like this, like the texture on the surface of an object, so it is called lung texture.
Once a pneumothorax occurs and the lungs are compressed, the lung belt and the middle belt of the lung will inevitably move down and move inward, which can show the result of being compressed with visible lung markings on imaging.
Where no lung markings appear, the area on the x-ray will become clear, and a dividing line with the lung markings is the pneumothorax line. This is the principle presented by the pneumothorax line. Anatomically, this line is also the pleural line.
Spontaneous pneumothorax is a common case in clinical practice. Like Xie Wanying, who was an emergency patient in a car accident, she was not in the hospital. According to the usual practice, after the initial suspicion of pneumothorax, it is necessary to take a film and then deal with it.
It is equivalent to saying that taking a film and watching a film is of great significance to the diagnosis of pneumothorax. The following will talk about how it is going on.
Finding the pneumothorax line on X-ray film is the medical common sense of this disease. It is a medical student who must learn and understand as long as he encounters this disease in the clinic.
The greatest significance of the pneumothorax line is that the width of the pneumothorax can be measured according to the position of the pneumothorax line. Air band width is another proper term. As the name implies, it is the width of the non-lung marking area (gas-liquid area) outside the pneumothorax line (the pleural line shadow after shifting).
By measuring this width, it is possible to further estimate how much of the patient's lung on the affected side is collapsed.
Here is a rough comparison table: When the width of the air band is one quarter of the patient's chest, the lungs are compressed to about 35 percent. When the air band is one-third the width of the patient's chest, the lungs are compressed to 50 percent. When the air band is half the width of the patient's thorax, the lungs are compressed by 65%. If the width of the air band reaches two-thirds of the patient's thorax, it is a super early warning: this means that the patient's lung on the affected side has been compressed to 90%.
Wei Shangquan stammered and continued: "Now visually, the patient's left pleural line has shifted, and the width of the air belt is estimated to be less than one-third of the thorax, so the patient's left lung has collapsed by about 40%."
What is the significance of calculating the compressed volume of this lung?
The inspection reports are to be used as the basis for further guiding the formulation of clinical treatment strategies. The results for the ratio of the lungs to be compressed are also for this purpose and serve as medical evidence for the treatment of the patient.
Doctors cannot treat patients without evidence. What method to use, how to treat it, and to what extent it should be cured all depends on the evidence. This is what classmate Xie said to Hu Hao before.
The disease of spontaneous pneumothorax is a bit special. For patients with primary spontaneous pneumothorax, these patients have no other diseases, and the age group of patients basically belongs to young adults. These two characteristics indicate that the cause of the disease may be accidental, and the metabolism of the young body is stronger than that of the elderly patients, and it is easier for the body to repair itself. These factors are destined to be a disease that can occur and heal itself.