自发性气胸344例临床分析

Clinical anlysis of 344 cases of spontaneous pneumothorax

目的探讨自发性气胸的临床特点及治疗选择。方法回顾性分析我院1998～2007年344例自发性气胸的临床特点、治疗方法。结果单纯性气胸58例，肺被压缩20％以下者内科保守卧床疗法平均6．25天治愈。肺被压缩21—30％者68例抽气治疗平均8．3天治愈。肺被压缩31％以上者218例给予胸腔闭式引流术治疗，其中张力性气胸肺复张平均9．2天，交通性气胸平均18．2天，液气胸平均14．6天，内科治疗总有效率93．6％，死亡7人。结论自发性气胸应采取综合治疗，单纯性气胸症状轻微可内科保守治疗。肺被压缩30％以上呼吸困难者应及时做胸腔闭式引流术，置管时间不宜超过15天，对交通性气胸、液气胸可适当延长，但不宜超过30天，如不愈可考虑外科治疗。

Objective To dicuss spontaneous pneumothorax aetiological agent and mechanism. Methods The study examined the clinical characteristic and treatment methods of 344 cases of spontaneous pneumothroax from 1998 to 2007 in our hospital. Results These were 58 cases of simplex pneumothorax, and the lungs of these patients were compressed below 20%. These patients were treated by the methods of medicine conservative sickbed, with an average cured time being 6.25 days. The lungs of the 68 eases were compressed between 21% and 30%, who were treated by exhausting, with an average cured time being 8. 3 days. The lungs of the other 218 cases were compressed above 31% , who were given the closed thoracic drainage treatment, with varied eured time. The oral rate of medical treatment was 93.6%. 7 patients died. Conclusion Simplex spontaneous pneumothorax should be treated integration, and by medical conservation method if the symptoms are not severe. For the patients whose lungs compressed above 30% and with symptoms of dyspnea, they should be given closed thoracic drainge treatment in time, with the total time of less than 15 days. For the patients of ehamel pneumothorax and liquid and gas pneumothorax, the drainage time can be longer, but no more than 30 days. If the patients are not cured, the surgery treatment can be eonsideral.