自发性纵隔气肿的临床特征及预后分析

Clinical Characteristics and Prognosis of Spontaneous Pneumomediastinum

目的探讨自发性纵隔气肿的临床特点,治疗及预后。方法回顾性分析我院2015年7月至2018年4月收治的43例纵隔气肿临床资料,筛选出自发性纵隔气肿与继发性纵隔气肿进行比较分析。结果自发性纵隔气肿12例,男9例,女3例,平均年龄(17.3±2.1)岁。继发性纵隔气肿31例,男25例,女6例,平均年龄(46.9±14.0)岁,差异有统计学意义(P<0.05)。自发性纵隔气肿最常见的症状为胸痛、胸闷,与继发性纵隔气肿相比,差异比无统计学意义(P>0.05)。自发性纵隔气肿予卧床休息、吸氧、止痛及预防使用抗生素等保守治疗,无并发症,均好转出院,平均住院时间(7.3±2.0)天。继发性纵隔气肿除常规治疗外,还需行切开引流、手术等治疗,平均住院时间(15.0±5.8)天,差异有统计学意义(P<0.05)。结论自发性纵膈气肿是一种良性疾病,好发于青年男性,临床表现无特异性,以胸痛、胸闷为主,保守治疗有效,预后良好,复发率低。

Objective To investigate the clinical characteristics,treatment and prognosis of spontaneous pneumomediastinum.Methods We retrospectively reviewed 43 patients diagnosed with pneumomediastinum between July 2015 and April 2018,Spontaneous pneumomediastinum was compared with secondary pneumomediastinum.Results There were 12 cases of spontaneous pneumomediastinum,9 males and 3 females.the mean age of the patients was 17.3±2.1 years.There were 31 cases of secondary pneumomediastinum,25 males and 6 females,the mean age of the patients was 46.9±14.0 years,the difference was statistically significant(P﹤0.05).The most common complaints were chest pain and dyspnea,the difference was not statistically significant(P﹥0.05).All patients with spontaneous pneumomediastinum received bed rest,oxygen therapy,pain medications,and prophylactic antibiotics.There were no complications related to SPM,the mean length of hospital stay was 7.3±2.0 days.In addition to conventional treatment,secondary pneumomediastinum requires treatment such as incision drainage and surgery.The mean length of hospital stay was 15.0±5.8 days,the difference was statistically significant(P﹤0.05).Conclusion SPM is a benign condition that often affects young males,with chest pain or dyspnea.Treatment is expectant and recurrence is low.