— 生理適應 · HARD · MCQ —
張力性氣胸病人，哪項評估結果最令人擔憂？
Which assessment finding in a patient with a tension pneumothorax is most concerning?
- AHyper-resonance on percussion叩診呈過度回響音
- BDiminished breath sounds on the affected side患側呼吸音減弱
- CSubcutaneous emphysema皮下氣腫
- DTracheal deviation✓ 正解氣管偏移
— Explanation · 中文詳解 —
張力性氣胸（Tension pneumothorax）屬於醫療緊急狀況。當胸腔內氣體無法排出，壓力持續堆積，會將縱隔結構（包含氣管與心臟）推向健側。氣管偏移（Tracheal deviation）是張力性氣胸的典型且晚期徵兆，意味著心輸出量因靜脈回流受阻而嚴重下降，病人可能隨時發生心跳停止，需緊急進行針刺減壓。
Tracheal deviation is the most concerning finding in a tension pneumothorax because it indicates severe mediastinal shift. This shift compresses the vena cava, impairing venous return and leading to potential cardiovascular collapse. While hyper-resonance and diminished breath sounds are present, tracheal deviation signals an immediate life-threatening emergency requiring needle decompression.