{"id":18210,"date":"2020-01-25T05:14:54","date_gmt":"2020-01-24T21:14:54","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=18210"},"modified":"2020-02-28T06:13:09","modified_gmt":"2020-02-27T22:13:09","slug":"nejm%e4%b8%b4%e5%ba%8a%e5%8c%bb%e5%ad%a6%e5%bd%b1%e5%83%8f%ef%bc%9a%e6%8d%bb%e5%8f%91%e9%9f%b3%e4%b8%8e%e7%9a%ae%e4%b8%8b%e6%b0%94%e8%82%bf","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=18210","title":{"rendered":"[NEJM\u4e34\u5e8a\u533b\u5b66\u5f71\u50cf]\uff1a\u637b\u53d1\u97f3\u4e0e\u76ae\u4e0b\u6c14\u80bf"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.nejm.org\/multimedia\/images-in-clinical-medicine\" class=\"\">IMAGES IN CLINICAL MEDICINE<\/a><\/p>\n\n\n\n<h1 class=\"wp-block-heading\">Crepitus and Subcutaneous Emphysema<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Yehia Saleh and Ahmad Alratroot<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">N Engl J Med 2020; 382:e1<br \/>DOI: 10.1056\/NEJMicm1907386<\/h3>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/www.nejm.org\/na101\/home\/literatum\/publisher\/mms\/journals\/content\/nejm\/2020\/nejm_2020.382.issue-1\/nejmicm1907386\/20191227\/images\/img_large\/nejmicm1907386_f1.jpeg\" alt=\"\"\/><\/figure>\n\n\n\n<p>An 86-year-old woman with a history of severe emphysema presented to the emergency department with sudden-onset shortness of breath. Two weeks earlier, she had been treated for community-acquired pneumonia that was complicated by a pneumothorax on the right side, leading to the temporary insertion of a chest tube. The drain was removed before the patient was discharged, without complication. On examination during the current presentation, the oxygen saturation was 82% while the patient was breathing ambient air, and breath sounds were diminished in the right hemithorax. Extensive palpable crepitus could be clearly visualized in the neck (see&nbsp;<a href=\"https:\/\/www.nejm.org\/do\/10.1056\/NEJMdo005660\/full\/?requestType=popUp&amp;relatedArticle=10.1056%2FNEJMicm1907386\">video<\/a>). Findings on computed tomography of the chest included emphysematous changes in the lungs, a moderate pneumothorax on the right side, and extensive subcutaneous emphysema. A chest tube was reinserted; however, the patient\u2019s clinical status continued to deteriorate, and ultimately a decision was made to pursue comfort care.<\/p>\n\n\n\n<p>\u4e00\u540d\u4e25\u91cd\u80ba\u6c14\u80bf\u75c5\u53f2\u768486\u5c81\u5973\u6027\u60a3\u8005\u56e0\u7a81\u53d1\u547c\u5438\u56f0\u96be\u5230\u6025\u8bca\u79d1\u5c31\u8bca\u30022\u5468\u524d\uff0c\u60a3\u8005\u56e0\u793e\u533a\u83b7\u5f97\u6027\u80ba\u708e\u5e76\u53d1\u53f3\u4fa7\u6c14\u80f8\u63a5\u53d7\u6cbb\u7597\uff0c\u5e76\u7559\u7f6e\u53f3\u4fa7\u80f8\u7ba1\u3002\u60a3\u8005\u51fa\u9662\u524d\u62d4\u9664\u80f8\u7ba1\uff0c\u4e14\u65e0\u4efb\u4f55\u5e76\u53d1\u75c7\u3002\u6b64\u6b21\u5c31\u8bca\u65f6\u4f53\u683c\u68c0\u67e5\u53d1\u73b0\uff0c\u60a3\u8005\u5438\u5165\u7a7a\u6c14\u65f6\u6c27\u9971\u548c\u5ea682%\uff0c\u53f3\u4fa7\u547c\u5438\u97f3\u51cf\u4f4e\u3002\u9888\u90e8\u53ef\u89c1\u5e7f\u6cdb\u6c14\u80bf\u8868\u73b0\u3002\u80f8\u90e8CT\u53d1\u73b0\u80ba\u5185\u6c14\u80bf\u6539\u53d8\uff0c\u53f3\u4fa7\u4e2d\u7b49\u91cf\u6c14\u80f8\uff0c\u5e7f\u6cdb\u76ae\u4e0b\u6c14\u80bf\u3002\u518d\u6b21\u7f6e\u5165\u80f8\u7ba1\uff1b\u7136\u800c\uff0c\u60a3\u8005\u75c5\u60c5\u6301\u7eed\u6076\u5316\uff0c\u6700\u7ec8\u51b3\u5b9a\u91c7\u53d6\u548c\u7f13\u6cbb\u7597\u63aa\u65bd\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"<p>IMAGES IN CLINICAL MEDICINE Crepitus and Subcutaneous E [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[16,13],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18210"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=18210"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18210\/revisions"}],"predecessor-version":[{"id":18231,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/18210\/revisions\/18231"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=18210"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=18210"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=18210"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}