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  瘦高体型男性占比高达60%至90%。

  多家权威医疗机构数据显示,20岁到35岁青壮年原发性气胸发病率呈上升趋势。所谓气胸,其本质是胸腔里出现了不该存在的气体,如同气球被扎破后漏气,当肺部表面形成破口,气体从肺内漏入胸膜腔,压迫肺组织导致塌陷,患者就会出现突发胸痛、呼吸困难甚至休克等症状。

  气胸分为原发性和继发性两类,前者多见于无基础性疾病的健康青年,后者则与肺结核、慢阻肺、间质性肺病等肺部疾病相关。年轻人的发病原因大多数为原发性气胸,这类患者中瘦高体型男性占比高达60%至90%。

  瘦高青年成气胸高危群体,甚至有网友热议,“身高180厘米、体重55千克的‘纸片人’最危险”,这是什么原因?

  其一是先天性发育特征,瘦高人群在青春期胸廓纵向生长较快,肺部为适应胸廓容量被动拉伸,导致肺尖部弹力纤维发育不良,易形成肺大疱(薄壁气囊);其二是生物力学影响,此类人群肺尖部承受的机械应力更大,剧烈运动、屏气动作(如举重、潜水)或剧烈咳嗽时,胸腔内压骤增易引发肺大疱破裂;其三是隐匿性疾患,约90%原发性气胸患者通过CT检查可发现肺大疱,但多数人平时无症状,相当于体内埋了颗“定时炸弹”。

  临床上,气胸的治疗方法包括保守治疗、胸腔闭式引流及手术干预等,各有其针对性。

  保守治疗适用于首次发作且肺压缩<30%的患者,但该疗法复发风险高。胸腔闭式引流是急救首选,但对治疗多发肺大疱效果有限。目前微创技术已成气胸治疗的主流。微单孔胸腔镜手术可通过仅2厘米到3厘米的切口,精准切除肺大疱并完成胸膜固定,将气胸复发率从50%降至5%以下。该术式出血量不足10毫升,患者术后2天即可出院。

  给“竹竿青年”的健康忠告——

  规避高危动作:避免潜水、跳伞、举重等需要屏气的活动,健身时避免过度负重。

  呼吸道健康管理:控制咳嗽、便秘等增加胸腔压力的行为,戒烟可大幅降低气胸发生风险。

  定期筛查:瘦高体型者建议每年接受低剂量CT检查,及时发现肺大疱。

  复发预警:首次气胸治愈后3个月到6个月内避免剧烈运动,若出现突发胸痛需立即就医。

  (来源:上观新闻作者赵德平为上海市肺科医院胸外科主任医师) 穿越画江湖之不良人 - 感受最真实的互动魅力的相关文章 汪苏泷十万伏特2.0巡回演唱会的相关文章
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