慢性阻塞性肺气肿并发自发性气胸外科治疗分析

Analysis of surgical therapy for chronic obstructive emphysema complicated with spontaneous pneumothorax

目的总结慢性阻塞性肺气肿并发自发性气胸的外科治疗经验。方法回顾性分析32例慢性阻塞性肺气肿并发自发性气胸患者行外科手术治疗的临床资料。11例行胸腔镜辅助小切口手术,21例行常规开胸手术。结果术后胸腔闭式引流时间(7.4±4.7)d。术后死亡1例,肺持续漏气时间>7d9例,心律失常5例,皮下气肿2例。术后3个月、6个月PaO2较术前显著提高,SatO2提高,PaCO2下降,差异有统计学意义。结论慢性阻塞性肺气肿并发自发性气胸患者行肺大疱切除术可行,术后早期可改善患者症状,提高生存质量。

【Objective】 To summarize the experience of surgical therapy for chronic obstructive emphysema complicated with spontaneous pneumothorax.【Methods】 32 patients with chronic obstructive emphysema complicated with spontaneous pneumothorax were retrospectively analyzed.Video-assisted minithoracotomy was performed on 11 patients,standard thoracotomy was performed on the other 21 cases.【Results】 The postoperative drainage lasted for（7.4±4.7） days.15 postoperative complications occurred,in which 9 cases of persistent air leakage were observed,arrhythmia in 5 cases,subcutaneous emphysema in 2 cases,and one died of severe pulmonary infection.Compared with preoperative values,there is improvement in PaO2 and O2 Saturation,decrease in PaCO2.【Conclusions】 It is safe and reliable to perform surgery for resection of bullae in chronic obstructive emphysema complicated with spontaneous pneumothorax.