每日一题_2023.04.02

A 17-year-old girl involved in a car accident presents to the emergency department with penetrating chest trauma to her left side. She is having difficulty breathing and has an oxygen saturation of 86%. After x-ray of the chest is performed, a chest tube is placed, and her oxygen saturation improves. Which of the following is responsible for her difficulty breathing upon presentation?

一名涉及车祸的17岁女孩出现了左侧胸部穿透性创伤，前往急诊科就诊。她呼吸困难，氧饱和度为86％。进行胸部X线检查后，放置了胸管，并且她的氧饱和度得到改善。以下哪项是导致她在就诊时呼吸困难的原因？

(A)  Her intrapleural pressure is equal to atmosphere pressure during inspiration她在吸气期间胸腔内压力等于大气压

(B)  Her intrapleural pressure is less than atmospheric pressure during inspiration她的胸腔内压力在吸气时低于大气压

(C)  Pain from the trauma has made it difficult to breathe创伤带来的疼痛使他呼吸困难

(D)  Pressure within the pericardial space is increased relative to the pleural space心包腔内压力相对于胸膜腔增加

(E)  The elastic force of the chest wall is pulling it inward胸壁的弹性力将其向内拉

答案解析：

病人的穿透性胸部伤口使她的胸膜腔与大气相通。因此，当她试图吸气时，她的胸腔扩张，但空气通过伤口进入，平衡了压力;这阻止了肺的正常扩张。如果在呼气过程中空气不能通过伤口逸出，这被称为张力性气胸，在这种情况下，每次呼吸后胸腔内的自由空气量会增加。

正确答案：A