自发性气胸160例临床分析

Clinical Analysis of 160 Cases with Spontaneous Pneumothorax

本文回顾分析本所自1988年至1992年收治的160例气胸患者,其中慢性阻塞性肺部疾病(COPD)占140例,与非COPD 20例对比分析,发现前者病史长、年龄大(>50岁以上)、肺反复感染、肺功能差、易产生自发性气胸,且多为反复性、多房性、及交通性气胸的特点。呼吸困难程度与肺受压缩面积不成比例。故在治疗上有一定难度。特别是张力性气胸和交通性气胸者在一次胸穿抽气肺未复张时,或肺压缩面积虽然不大,但肺功能差,临床症状明显者,我们就提倡进行胸腔闭式引流术,用持续排气减压方法治疗,结果证实疗效甚佳,值得推广。

160 cases with spontaneous pneumothorax were reported. Among them there were 140 eases with chronic obstructive pulnomary diseases (COPD) and 20 cases without. The former ones were easy to get pneumothorax because of old age, recurrent infection of lungs and poor lung function. They had charatheristics of segregation, localigation and open-pneumothorax, and the pressed areas of lungs were not proportional to the symptoms. So managements were different from that of the latter Ones. Etiological treatment and gas abstraction pleuroceutesis were very important. Closed drainage was adopted in tension and open-pneumothorax when the pressed lungs were not inflated after the first pleuroeentesis, or the pressed areas were not large but with poor lung function and obvious symptoms. It was proved that persistant negative pressed abstraction had definite effects and was worth spreading. This paper analyzes systemtically the classification, etiology of spontaneous pneumothorax, different features of pneumothorax between old and young age, management as well as prevention. It may be used as reference for medical workers.