青少年自发性气胸胸腔镜手术后对侧复发的影响因素分析

Influence Factors for Contralateral Recurrence of Spontaneous Pneumothorax Following Thoracoscopic Surgery in Adolescents

目的探讨青少年自发性气胸行胸腔镜手术治疗后对侧复发的影响因素。方法青少年自发性气胸患者255例,其中术后对侧复发患者43例,未复发212例。对比术后对侧复发组和术后未复发患者的一般情况、X线胸片结果、术中情况、手术情况等,采用单因素和多因素logistic回归分析对侧复发的影响因素。结果单因素显示两组身高、体重指数、发病次数、胸廓横径/前后径、胸廓长度、术中肺泡存在状况比较,差异有统计学意义(P<0.05)。logistic回归分析显示胸廓横径/前后径、术中肺泡存在状况、体重指数、发病次数为术后对侧复发的影响因素。结论青少年自发性气胸并行胸腔镜手术的患者,如果患者体型瘦长,多次发病,扁平胸廓,且术中可见多发多处肺大疱生长者,则患者对侧复发的风险明显增加。

Objective To investigate the influence factors for contralateral recurrence of spontaneous pneumothorax following thoracoscopic surgery in adolescents. Methods Two hundred and fifty-five adolescents with spontaneous pneumothorax were enrolled in the study,including 43 patients with postoperative contralateral recurrence and 212 patients without recurrence. The demographic characteristics,X-ray imaging,perioperative and operative information were compared between patients with and without contralateral recurrence. The influence factors for contralateral recurrence were analyzed by univariate and multivariate logistic regression analysis. Results Univariate analysis suggested that there were significant differences in height,body mass index,onset frequency of spontaneous pneumothorax,thoracic transverse diameters to anteriorposterior diameters,thoracic length and perioperative alveolus occurrence between two groups（ P 〈 0.05）.Multiple logistic regression analysis suggested that thoracic transverse diameters to anteriorposterior diameters,perioperative alveolus occurrence,body mass index and onset frequency of spontaneous pneumothorax were the influence factors for postoperative contralateral recurrence. Conclusion The patients with slim body,several onset frequencies,flat chest and several pulmonary bulla observed during operation have increased risks of contralateral recurrence in adolescents with spontaneous pneumothorax undergoing thoracoscopic surgery.