原发性自发性气胸术后复发相关因素的临床分析

Clinical analysis of related factors of postoperative recurrence of primary spontaneous pneumothorax

目的探讨影响原发性自发性气胸术后复发的相关因素。方法收集该院2000年1月～2007月12月352例接受手术治疗的原发性自发性气胸病例的临床资料,随访并计算术后复发率;对与复发可能相关的因素进行单因素和多因素分析。结果得以随访的325例患者中,有14例复发,复发率为4.3%。单因素分析结果:术后气胸复发与患者术前气胸发作次数、胸膜固定术、体重及体重指数有关(P<0.05);而与性别、年龄、身高、发病部位、术式、术中肺大泡分型及术后引流时间无关(P>0.05)。多因素分析结果:患者体重指数、术前气胸发作次数、胸膜固定术是预测术后气胸复发的独立因素(P<0.05)。结论体重指数、术前气胸发作次数及胸膜固定术影响原发性自发性气胸术后复发。

【Objective】 To analyze the relative factors affected the recurrence of primary spontaneous pneumothorax after operation,and discuss the possible methods to improve the effect of operation.【Methods】 The clinical data of 325 cases with primary spontaneous pneumothorax were collected,which had undergone thoracic operation at Jilin University First Hospital Department of Thoracic Surgery from 2000/1 to 2007/12.The age at the time of operation,sex,height,body mass index（BMI）,Position of episode,number of episode,VATS/minithoractomy,tyPe,pleurodesis and time of drainage were recorded,and the postoperative recurrence rate was calculated.Univariate and multivariate analysis were performed for possible factors related to recurrence.【Results】 The overall recurrence rate was 4.3%.The result of univariate analysis： the number of episode,weight,BMI,type and pleurodesis were related factors of recurrence（P 0.05）.The sex,height,age of episode,position of ePisode and time of drainage were not related to the rate of recurrence.The result of multivariate analysis： BMI,preoperative episodes of pneumothorax,pleurodesis were the independent predictive factors of postoperative recurrence of pneumothorax.【Conclusion】 BMI,number of episode and pleurodesis influence the postoperative recurrence of primary spontaneous pneumothorax.