慢性阻塞性肺疾病并发自发性气胸临床诊治探讨

The Clinical Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease Complicated with Spontaneous Pneumothorax

目的:探讨慢性阻塞性肺疾病并发自发性气胸临床诊治措施及效果。方法:选取笔者所在医院2012年3月-2013年3月收治的46例慢性阻塞性肺疾病并发自发性气胸患者作为研究对象,所有患者均经常规检查和影像学检查确诊,在常规综合治疗的基础上对其实施保守治疗或非保守治疗,观察其临床疗效。结果:本组行内科保守疗法14例,胸腔穿刺抽气16例,胸腔闭式引流14例,肺修补手术1例,45例治愈出院,治愈率为97.83%;1例患者由于呼吸衰竭和心力衰竭严重,抢救无效死亡,死亡率为2.17%。结论:慢性阻塞性肺疾病并发自发性气胸易漏诊误诊,病死率高,结合肺X线或胸部CT扫描能够提高诊断准确率,确诊后及时采取对症治疗临床效果显著,能够降低病死率。

Objective：To investigate the clinical diagnosis and treatment measures and effect of chronic obstructive pulmonary disease complicated with spontaneous pneumothorax.Method：46 cases of chronic obstructive pulmonary disease complicated with spontaneous pneumothorax in our hospital from March 2012 to March 2013 were selected as research objects.All patients were treated by routine examination and imaging examination,they were treated with conservative treatment or non conservative treatment on the basis of routine treatment,the clinical effects of patients were observed.Result：The group underwent department of internal medicine conservative therapy in 14 cases,pleural puncture pumping gas in 16 cases,closed thoracic drainage in 14 cases,1 case of lung repair operation,45 cases were cured,the cure rate was 97.83%.1 patient with respiratory failure and heart failure,rescue invalid death,mortality was 2.17%.Conclusion：Chronic obstructive pulmonary disease complicated with spontaneous pneumothorax is easily misdiagnosed,with high mortality rate,combining X-ray pulmonary or scan of chest CT can improve the accuracy of diagnosis,timely symptomatic treatment after diagnosis,the clinical effect is significant,can reduce the mortality rate.