青少年自发性气胸30例诊治分析

Diagnosis and treatment of 30 cases of spontaneous pneumothorax in adolescent

目的探讨青少年自发性气胸的临床特征及CT诊断价值。方法回顾性分析临床证实的30例青少年自发性气胸的资料。结果 30例中,全部为男性,瘦长体型26例。单侧气胸27例,双侧3例,复发性6例。原发性9例,继发性21例(CT及高分辨率CT发现胸膜下肺气肿、肺大疱19例,陈旧性结核伴牵拉性肺气肿2例)。术前CT均能发现气胸。行闭式引流术13例,其中住院期间气胸消失8例。22例接受手术治疗(包括6例开胸手术,12例胸腔镜辅助腋下小切口手术,4例全胸腔镜手术),随访至今未见复发。结论青少年自发性气胸有一定的临床及影像学特点,常规保守治疗无效者应采取进一步的手术治疗。

Objective To investigate the clinical features and CT diagnosis value of spontaneous pneumothorax in adolescents.Methods A retrospective analysis of clinical and imaging data of 30 cases of adolescents spontaneous pneumothoraxconfirmed clinically.Results 30 patients wereall male,of them slender body type in 26 cases.Unilateral pneumothorax in 27 cases,bilateral in 3 cases,recurrent in 6 cases.Primary in 9 cases,secondary in 21 cases（CT and high-resolution CT showed the subpleural emphysema and pulmonary bulla in 19 cases,pulmonary tuberculosis with tractional emphysema in 2 cases）.Preoperative CT could find pneumothorax in all cases.13 cases with closed thoracic drainage,the pneumothorax disappeared in 8 cases during hospitalization.22 cases accepted surgery therapy（including open heart surgery in 6 cases,subaxillary small incision surgery with thoracoscope assisted in 12 cases,total thoracoscope surgery in 4 cases）.The recurrence had not yet seen follow-up till now.Conclusions Certain clinical and imaging characteristics may exist in adolescents spontaneous pneumothorax in spontaneous.If conservative treatment to the disease is invalid,operation treatment should be taken further.