肺结核患者机械通气并发气胸的临床分析

Analysis on the Treatment of Mechanical Ventilation Salvage on Pulmonary Tuberculosis Patients Combined with Pneumothorax

目的分析肺结核患者应用机械通气过程中并发气胸的诊治,为减少此类并发症提供参考。方法回顾性分析2006年8月至2011年8月于首都医科大学附属北京胸科医院行机械通气的11例肺结核合并气胸患者的临床表现,气胸原因,治疗和转归情况。对比行胸腔闭式引流治疗前后血气分析结果。结果 11例患者均给予胸腔闭式引流及继续机械通气治疗,其中8例治愈,2例死于多脏器功能衰竭,1例死于呼吸循环衰竭。行胸腔闭式引流治疗前后血气分析比较,治疗后PaCO2及PaO2显著上升(P<0.05)。结论肺结核机械通气患者合并气胸危害大,及时诊断、快速胸腔闭式引流以及防治气胸至关重要。

Objective To analyze the diagnosis and treatment of pneumothorax during mechanical ventilation salvage on pulmonary tuberculosis patients,to provide reference for reducing the complication.Methods Clinical manifestation,pneumothorax reason,treatment and prognosis of 11 mechanical ventilation salvage on pulmonary tuberculosis patients combined with pneumothorax from Beijing Chest Hospital of Capital Medical University from August 2006 to August 2011 were analyzed.The PaCO2 and PaO2 analysis before and after closed drainage of thoracic cavity treatment was compared.Results All of the 11 patients had drainage of thoracic cavity and continuous mechanical ventilation,8 patients were cured,2 patients died of multiple organ failure,1 patient died of respiratory failure.After treatment of closed drainage of thoracic cavity,PaCO2 and PaO2 increased（P〈0.05）.Conclusion Prompt diagnosis and timely drainage of thoracic cavity are important for mechanical ventilation salvage on pulmonary tuberculosis patients combined with pneumothorax.