82例自发性气胸的治疗体会

Experience in the treatment of 82 cases of spontaneous pneumothorax

目的了解自发性气胸治疗方法的选择及治疗。方法对2004年以来自发性气胸的临床诊治资料进行回顾性分析。结果82例自发性气胸患者突发胸痛、气急80例。14例肺容积被压缩<30%,其中保守治疗6例,穿刺排气8例,在1周内全部治愈;68例肺压缩>30%,均经胸腔闭式引流排气,平均住院时间9d,治愈率97·1%,并发皮下气肿3例。其中有6例复发性气胸经胸膜粘连治疗治愈5例,2例自发性血气胸经手术治疗未再复发。结论根据肺压缩程度分别采用保守、留置针穿刺或胸腔闭式引流排气法,可完全治愈自发性气胸,并发症少。胸膜粘连或手术可有效复发性气胸。

Objective To explore therapeutic methods and effect of spontaneous pneumothorax. Methods Clinical data of spontaneous pneumothorax patients since 2004 were retrospectively analyzed. Results Among 82 inpatients suffered of spontaneous pneumothorax, 80 cases manifested suddenly as chest pain and breathlessness. The lung capacity in 14 patients was reduced by 30%. 6 cases were treated by conservative method. The pneumothorax in 8 cases were exhausted by the pierce with venipuncture needle. The lung capacity reduced by more than 30% in 68 patients was treated by closed thoracic drainage. The average period in hospital stay was 9 days and the curative rate was 97. 1%. Only 3 cases showed subsequent syndrome as subcutaneous emphysema. 5 of 6 cases suffered from recurrent pneumothorax were cured by conglutination of pleural cavity. 2 cases of spontaneous hemopneumothorax were treated and no recrudesee was observed. Conclusion The spontaneous pneumothorax could be cured by either conservative, venipunctural treatment, or closed thoracic drainage according to the extent of lung compress. Only a few comlications are observed. Recurrent pneumothorax is effectively treated by conglutination of pleural cavity or operation.