老年慢性阻塞性肺疾病并发自发性气胸29例临床分析

Clinical analysis of 29 old patients with chronic obstructive pulmonary disease and complication of spontaneous pneumothorax

目的:探讨老年慢性阻塞性肺疾病(COPD)并发自发性气胸患者的临床特点。方法:回顾分析29例COPD并发自发性气胸患者的临床资料,其中行胸膜腔穿刺抽气减压6例,胸腔闭式引流19例,4例闭合型气胸患者经绝对卧床休息后肺复张。结果:25例治愈,4例死亡。结论:老年COPD并发自发性气胸发病诱因多样,临床症状多不典型,体征易被原发病掩盖,年龄大,体质差,病情重,变化快,必须及早作X线检查确诊,治疗时以综合措施为主,尽早排气,缓解病情,降低死亡率。

Objective：To explore the clinic character of chronic obstructive pulmonary disease （COPD） complicated with spontaneous pneumothorax. Methods： 25 cases were in cure,and 4 cases were dead. Results： 39 cases had complete remission （78%）,7 cases had partial remission （14%）,and 4 cases had light remission （8%） with total efficiency as 92%. Adverse reactions included drowsiness,constipation,dizziness,nausea,vomiting and so on. Conclusion. With various cause, atypical clinic symptoms, the physical signs of COPD patients are easy to be covered by primary diseases. These patients are usually of old age, weak physical status, and the disease is always severe and rapid changeable. So it is important to apply X- ray examination at the earliest, and employ combined treatment to relieve pneumothorax and to lower the mortality.