A single institution experience using the LigaSure vessel sealing system in video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

This study sought to report our 6-year experience with the LigaSure vessel sealing system（LVSS） in videoassisted thoracoscopic surgery（VATS） for primary spontaneous pneumothorax.A series of 180 consecutive patients with primary spontaneous pneumothorax were operated on in our institution from May 2005 to December 2010.Intraoperatively,large lesions（bullae or blebs） with a diameter more than 2 cm were resected by staplers,and the residual lesions were treated by LVSS.LVSS was also used to ablate the apical area when no lesions were found.Conventional apical pleural abrasion was done in all cases.All patients were successfully treated using VATS with minimal perioperative bleeding.The mean operating time was 76 minutes（range,43-160 minutes） for single-side procedures and 169 minutes（range,135-195 minutes） for bilateral procedures,the mean number of applied staples was 1.93 per patient（range,0-8 days）,the duration of drainage was 3.8 days（range,2-15 days）,and the duration of hospital stay was 5.8 days（range,3-16 days）.Postoperative complications included persistent air leak（〉 5 days） in 11 cases（6.1%） and residual pneumothorax in 6（3.3%）.None required reoperation.The mean duration of follow-up was 57 months（range,24-105 months）.Recurrence was seen in three cases（1.7%）,and all underwent another operation thereafter.None of the lesions in the relapse cases received ablation with LVSS in the first operation.LVSS can optimize VATS for primary spontaneous pneumothorax and reduces the use of single-use staples.The method is safe,easy to use,and cost-effective and produces satisfactory results.

FAMILIAL SPONTANEOUS PNEUMOTHORAX

it is believed that there are some factors related with familial spontaneous pneumothorax. These factors are hereditary,homologous leucocytic antigen (HLA),α-antrypsin (α-AT) and lanky somatotype,According to the analysis or 7 cases with the disease and references review, in this paper,we believe that the familial spontaneous pneumothorax is related with HLA,and α-AT,ut not every patient has this relation. The phenotype of HLA and α-AT can he passed on to next generation from either father or mother. It is also believed that the formation of spontaneous pneumothorax in this group is related with the maldevelopment of local lung and bronchiole rather than with the lanky somatotype.

Matrix Metalloproteinase-9 Promoter Polymorphism in Primary Spontaneous Pneumothorax

Primary spontaneous pneumothorax （PSP） is a common clinical problem occurring in apparently healthy subjects. However emphysema like changes （ELC） in patients with （PSP） has been demonstrated, which is associated with the degradation of extraceilular matrix （ECM）. MMP-9 has been proposed to play a role in the development of emphysema and is involved in the digestion of （ECM）. Among several polymorphic changes reported in MMP-9 regulatory region, the C-1562T polymorphism increases its promoter activity Aim of the work： To test the hypothesis that the MMP-9 C-1562T polymorphism has a role in the occurrence of PSP. Subjects and Methods： MMP-9 （C-1562T） genotypes of 104 PSP patients and 97 healthy subjects （control） were determined by the polymerase chain reaction, followed by a restriction fragment length polymorphism analysis. Results： This study showed that the genotype frequency for MMP-9 1562 C 〉 T differed significantly between healthy individuals and PSP patients, with higher T allele in MMP-9 promoter in PSP patients, and the C/T ＋ T/T genotypes significantly modified the risk of developing PSP, and were associated with increased risk for PSP. Conclusion： MMP-9-1562C/T genotype may be a potentially indicative factor for susceptibility to PSP, that is, genotypes with the T allele significantly increase the risk of development of PSP.

Analyzing the CT Features of Primary Spontaneous Pneumothorax and Its Application Value

Objective:To explore the performance characteristics of CT examination in primary spontaneous pneumothorax(PSP)and the effect of pleurodesis on patients with PSP.Methods:Sixty-four patients with PSP,who received medical care in the Affiliated Hospital of Hebei University from January 2017 to December 2021,were selected as the research subjects,of which 40 were male and 24 were female patients.All 64 patients were examined by X-ray and CT;the density,enhancement,and morphology of the pneumothorax were observed and analyzed,and the classification of pneumothorax was done.Results:The clinical analysis of 64 patients with PSP showed that the number of cases with unilateral pneumothorax was 42,accounting for 65.63%,whereas the number of cases with bilateral pneumothorax was 22,accounting for 34.37%.Among the cases of unilateral pneumothorax,the number of cases with left pneumothorax was 26,accounting for 61.90%,whereas the proportion of cases with right pneumothorax was 38.10%.When examined by CT,the diagnostic coincidence rate of 64 patients with PSP was 73.44%;using X-ray examination,the diagnostic coincidence rate of 64 patients with PSP was 92.19%.Conclusion:The detection accuracy of CT is higher than that of X-ray examination,which may improve the treatment effect in PSP,ensure the accuracy of findings,and facilitate follow-up treatment as well as the effect of postoperative analysis.

Nonintubated uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

Objective： The objective of the current study was to evaluate the feasibility and safety of nonintubated nniportal video-assisted thoracoscopic surgery （VATS） for the management of primary spontaneous pneumothorax （PSP）. Methods： From November 2011 to June 2013, 32 consecutive patients with PSP were treated by nonintubated uniportal thoracoscopic bullectomy using epidnral anaesthesia and sedation without endotracheal intubation. An incision 2 cm in length was made at the 6th intercostal space in the median axillary line. The pleural space was entered by blunt dissection for placement of a soft incision protector. Instruments were then inserted through the incision protector to perform thoracoscopic bullectomy. Data were collected within a minimum follow-up period of 10 months. Results： The average time of surgery was 49.0 rain （range, 33-65 rain）. No complications were recorded. The postoperative feeding time was 6 h. The mean postoperative chest tube drainage and hospital stay were 19.3 h and 41.6 h, respectively. The postoperative pain was mild for 30 patients （93.75%） and moderate for two patients （6.25%）. No recurrences ofpneumothorax were observed at follow-up. Conclusions： The initial results indicated that nonintubated uniportal video-assisted thoracoscopic operations are not only technically feasible, but may also be a safe and less invasive alternative for select patients in the management of PSP. This is the first report to include the use of a nonintubated uniportal technique in VATS for such a large number of PSP cases. Further work and development of instruments are needed to define the applications and advantages of this technique.

Video-assisted thoracoscopic surgery (VATS) for bilateral primary spontaneous pneumothorax

Objective： To review our experience of the treatment of bilateral primary spontaneous pneumothorax （PSP） by video-assisted thoracoscopic surgery （VATS）. Materials and methods： Retrospective chart review was followed by an on-clinic or telephone interview. Patients were cared for by one thoracic surgeon in four medical centers or community hospitals in Northern and Central Taiwan. Thirteen patients with bilateral PSP underwent bilateral VATS simultaneously or sequentially from July 1994 to December 2005. Results： Twelve males and one female, with age ranging from 15 to 36 years （mean 23.1 years）, were treated with VATS for bilateral PSP, under the indications of bilateral pneumothoracis simultaneously （n=4） or sequentially （n=9）. The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. Eleven of 13 patients （84.6%） had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. The mean operative time was （45.6±18.3） min （range 25-96 min） and （120.6±28.7） min （range 84-166 min） respectively for the non-simultaneous （second VATS for the recurrence of contralateral side after first VATS） and simultaneous （bilateral VATS in one operation） procedures. There was no postoperative mortality. However, prolonged air leakage （〉7 d） occurred in one patient （7.7%） who recovered after conservative treatment. The mean duration of chest tube drainage was 3.1 d and the median follow up period was 3.4 years. Conclusions： VATS is a safe and effective procedure in the treatment of bilateral PSP. Bilateral VATS is only recommended for patients with simultaneously bilateral PSP, because the incidence of recurrence, even with visible bullae, was not so high in my group and in some previous literature. Bilateral VATS in a supine position should only be used in selective cases, because of possible pleural adhesion or hidden bullae on the posterior side.

An unusual cause of simultaneous bilateral spontaneous pneumothorax

INTRODUCTIONScrub typhus, a tropical febrile vector borne disease also known as ＂Tsutsugamushi disease＂, is caused by Orientia tsutsugamushi, a gram negative obligate intracellular slow growing bacteria. The infection is transmitted by the bite of larval stage （chiggers） mites belonging to the family Trombiculidae.

Simultaneous Bilateral Spontaneous Pneumothorax: Report of 6 Adult Patients

Background: Spontaneous pneumothorax (SP) refers to the spontaneous presence of air in the pleural sac(s) without iatrogenic or traumatic factors. The simultaneous bilateral SP (SBSP) is rare yet serious clinical condition which may pose a significant threat to patient’s life. Herein, 6 patients with SBSP managed in Sulaimaniyah Teaching Hospital (STH) over 6-year period (2006-2011) are reported with literature review. Methodology: A prospective clinical study. The diagnosis was made on clinical and radiographic grounds. The initial therapy was a bilateral tube thoracostomy (BTT) followed by chemical pleurodesis. Thoracotomy for excision of subpleural blebs or bullae and pleurectomy was performed for prolonged air leak (lasting >14 days). Results: There were 5 males (83.33%) and 1 female (16.67%) with a mean age of 34.8 years ranging between 20 and 50. All patients had presented with dyspnea and chest pain and were smokers. Three patients (50%) had primary (PSP) whereas the remaining had secondary (SSP) (chronic obstructive pulmonary disease—COPD, n = 2 and pneumonia, n = 1). None of the patients had recurrence. Unilateral thoracotomy was necessary in 5 patients (SSP, n = 3 and PSP, n = 2). Prolonged air leak was observed once postoperatively (16.7%) while mortality was nil. Conclusions: Prompt recognition of this rare yet potentially serious condition is crucial. The clinical diagnosis is straightforward with plain chest radiography being the most helpful workup. The initial therapy is via BTT followed by pleurodesis. Surgery is necessary for prolonged air leak and failure of the lung to expand.

Is There a Role for Chest Computed Tomography in Patients with Primary Spontaneous Pneumothorax?

Background: Primary spontaneous pneumothorax is a relatively common condition in young adults. Although blebs and bullae are frequently found in patients with primary spontaneous pneumothorax, they are very rarely the actual cause of the pneumothorax. Objective: To assess our experience with chest computed tomography evaluation in patients with recurrent spontaneous pneumothorax as compared to their histopathology findings. Study Design: A prospective study analysis. Materials and Methods: From January 2013 to December 2016, 38 consecutive patients with unilateral recurrent spontaneous pneumothorax underwent video-assisted thoracic surgery. Their chest computed tomography scans were reviewed and compared with their histopathology findings. Results: Thirty-six adult patients with unilateral recurrent spontaneous pneumothorax were included;their mean age was 33.9 years, and they all received video-assisted thoracic surgery and mechanical pleurodesis. Blebs or bullae were present in the chest computed tomography scans of fourteen patients (39%);of those fourteen patients, five (35.7%) had emphysematous changes in histopathology. Seventeen out of the thirty-six (47%) had no blebs or bullae in their chest computed tomography scans;of those seventeen patients, ten (59%) had emphysema like changes and seven (41%) had blebs in their histopathology studies. The remaining five patients (14%) had normal chest computed tomography scans. Conclusions: We conclude that preoperative chest computed tomography is not beneficial in every patient with recurrence of primary spontaneous pneumothorax.

Analysis of Recurrence and Influencing Factors of Spontaneous Pneumothorax After Thoracoscopic Surgery

This study was conducted to explore the factors that are influencing the recurrence of spontaneous pneumothorax after thoracoscopic surgery.Around 110 patients with spontaneous pneumothorax who underwent thoracoscopic bullectomy in Hebei Hospital from May 2017 to May 2021 were included in this study.The patients were divided into the recurrence group(15 cases)and the non-recurrence group(95 cases),and the influences of gender,age,smoking history,height,weight,operation time,the weight of the excised tissue,number of excised pulmonary bullae,postoperative chest tube maintenance time,duration of air leakage,and length of hospital stay on the recurrence of spontaneous pneumothorax after thoracoscopic surgery were investigated.This study found that the height/weight,operation time,duration of air leakage,number of pulmonary bullae removed,weight of the removed tissue,postoperative chest tube maintenance time,and duration of hospital stay in the recurrence group was 3.2±0.4,50.9±1.2,2.1±0.4,1.6±0.2,4.2±1.3,2.4±1.5 and 7.2±1.5,respectively.Meanwhile,the recurrence group was 2.6±0.3,50.8±1.3,1.3±0.2,1.8±0.9,4.4±1.2,4.1±1.7 and 6.9±1.6,respectively.After comparing the relevant factors between the recurrence group and the non-recurrence group,it was found that there was comparability between age,height/weight,duration of air leakage and postoperative chest tube maintenance time,where these factors were shown to affect the recurrence of spontaneous pneumothorax after thoracoscopic surgery,while gender,smoking,operation time,number of resected bullae,weight of resected tissue and length of hospital stay had no effect on recurrence after spontaneous pneumothoracoscopic surgery.In short,thoracoscopic bullectomy is the best clinical treatment for spontaneous pneumothorax,however the occurrence of recurrence of spontaneous pneumothorax after the operation,which is mainly influenced by the patient’s height/weight,postoperative air leakage duration,and chest tube maintenance time.Therefore,it is essential to pay attention to the surgical treatment of the patients,and fully identify the related factors of postoperative recurrence,thereby the follow-up clinical treatment can be carried out effectively.

Spontaneous Pneumothorax Complicating Miliary Tuberculosis: About a Case at the “Centre Medical Principal De La Gendarmerie Nationale Du Mali”

Introduction: Spontaneous pneumothorax is a rare but serious complication of tuberculosis. Miliary tuberculosis (MT) is a severe form of tuberculosis secondary to hematogenous spread of Mycobacterium tuberculosis. Objective: To report a case of MT complicated by pneumothorax. Methodology: This was a 25-year-old patient, farmer, followed up at the Pneumo-phtisiology department of the CHU du Point G for MT whose condition was improving after the introduction of anti-tuberculosis chemotherapy. He consulted again after experiencing chest pain. Clinical and imaging revealed a Spontaneous pneumothorax complicating MT. The treatment combined anti-tuberculosis chemotherapy, chest drainage and respiratory physiotherapy. Outcome was favorable with improvement of clinical and radiological signs. Conclusion: Pneumothorax complicating MT requires a reflective diagnostic approach and rapid management to improve its prognosis.

Spontaneous Bilateral Pneumothorax in a Healthy Young Adult: A Comprehensive Case Report

Background: Spontaneous bilateral pneumothorax in healthy young adults is a rare and challenging condition that defies conventional diagnostic and etiological paradigms. This case report explores the presentation, diagnostic evaluation, management, and potential contributing factors in a 29-year-old male with no prior medical history who experienced bilateral spontaneous pneumothoraces. Aim: This case report aims to shed light on the complexities of managing spontaneous bilateral pneumothorax, particularly in the absence of common risk factors. It underscores the need for a thorough assessment and ongoing research to unravel the enigma surrounding this condition. Case Presentation: A healthy 29-year-old male presented with acute chest pain and shortness of breath, ultimately diagnosed with bilateral spontaneous pneumothoraces. Despite the absence of typical risk factors, advanced imaging techniques revealed valuable insights into the diagnosis and management of this unique presentation. Conclusion: Spontaneous bilateral pneumothorax in healthy individuals presents diagnostic challenges and raises questions about potential genetic predisposition, connective tissue disorders, and lifestyle-related triggers. While the acute phase was effectively managed, this case underscores the importance of interdisciplinary collaboration and ongoing research to comprehensively understand this condition.

Diagnosis and treatment of primary spontaneous pneumothorax

Primary spontaneous pneumothorax(PSP) commonly occurs in tall,thin,adolescent men.Though the pathogenesis of PSP has been gradually uncovered,there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder.Herein,the literature is reviewed concerning mechanisms and personal clinical experience with PSP.The chest computed tomography(CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further management strategies.The development of video-assisted thoracoscopic surgery(VATS) has changed the profiles of management strategies of PSP due to its minimal invasiveness and high effectiveness for patients with these diseases.

Recurrent primary spontaneous pneumothorax in a large Chinese family: a clinical and genetic investigation

Background:Primary spontaneous pneumothorax(PSP)is a common manifestation of Birt-Hogg-Dubé(BHD)syndrome,which is an autosomal dominant disorder caused by mutation of the folliculin(FLCN)gene.This study was established to investigate the mutation of the FLCN gene and the phenotype in a family with PSP.Methods:We investigated the clinical and genetic characteristics of a large Chinese family with recurrent spontaneous pneumothorax.Genetic testing was performed by Sanger sequencing of the coding exons(4-14 exons)of the FLCN gene.Results:Among ten affected members in a multi-generational PSP kindred,with a total of 18 episodes of spontaneous pneumothorax,the median age for the initial onset of pneumothorax was 42.5 years(interquartile range:28.8-57.2 years).Chest computed tomography scan of the proband showed pulmonary cysts and pneumothorax.A novel nonsense mutation(c.1273C>T)in exon 11 of FLCN gene that leads to a pre-mature stop codon(p.Gln425*)was identified in the family.The genetic analysis confirmed the diagnosis of BHD syndrome in this family in the absence of skin lesions or renal tumors.Conclusions:A novel nonsense mutation of FLCN gene was found in a large family with PSP in China.Our results expand the mutational spectrum of FLCN gene in patients with BHD syndrome.

Erlotinib treatment for persistent spontaneous pneumothorax in non-small cell lung cancer： a case report

Spontaneous pneumothorax （SP） develops secondary to primary lung cancer. It has a very low incidence and accounts for less than 1% of all cases.1 Once SP develops, the prognosis is usually very poor, and majority of patients live no longer than 3 months.1,2Most patients with advanced stage can not undergo resection due to the poor general condition. Thus, chest tube drainage remains among the treatments of choice although it is not always completely effective in preventing recurrence. In refractory SP, patients would bear the chest tube for their whole life.3 Here we report a case of SP following chemotherapy in adenocarcinoma of the lung with multiple organs metastases. In this case, chest tube drainage was not effective in preventing recurrence of SP.However, the treatment was successful with oral erlotinib,an epidermal growth factor receptor tyrosine kinase inhibitor （EGFR-TKI）.

Postoperative management of spontaneous pneumothorax in arthroscopic shoulder superior capsular reconstruction:A case report and review of literature

Arthroscopic superior capsular reconstruction is an innovative technique for the irreparable rotator cuff tears,but spontaneous pneumothorax after surgery is very rare.The present case was a 66-year-old female with irreparable rotator cuff tears of the right shoulder,treated with the arthroscopic shoulder superior capsular reconstruction.The general anesthesia and operation went smoothly,but the patient experienced stuffiness in the chest and shortness of breath after recovery from anesthesia.Thoracic CT scans showed spontaneous pneumothorax in the right side,which was successfully treated by the conservative treatments(oxygen therapy)according to multidisciplinary team.Prompt and accurate early-stage diagnosis is necessary in controlling postoperative complications and standardized treatment is the key to relieve the suffering.Spontaneous pneumothorax after arthroscopic shoulder surgery has been rarely reported in previous literatures.

Spontaneous Bilateral Pneumothorax with Recurrent Pneumothorax: A Case Report

Aim: To report a rare case of spontaneous bilateral pneumothorax with recurrent pneumothorax. Background: Spontaneous bilateral pneumothorax is medical and surgical emergency. It is presence of free air in the bilateral pleural spaces. It rarely occurs at any age but usually young age without apparent precipitating etiology in healthy subjects without any existing pathology. Case Report: In present case, a non smoker, uneducated, young housewife was received in emergency in critical condition and admitted in Intensive Care Unit directly, Peoples Medical university Hospital, Nawabshah, and Sindh, Pakistan. She felt difficulty in breath and after few moments she complained chest pain on right side of chest. They rushed in emergency in Peoples Medical University hospital and diagnosed as case of pneumothorax and at the same time her symptoms started worsening and she developed central cyanosis. In emergency chest X-ray was done showing bilateral pneumothorax, patient developed respiratory distress, emergency bilateral chest intubation was done and due to SO2 drop. Patient was kept on mechanical ventilation. After 24 hours she was weaned off and she was vitally in stable state and shifted in medical department and after 2 weeks she was discharged well. After 3 days of discharge she again came in emergency X-ray shown right sided recurrent pneumothorax, chest intubation done and she was referred to Oojha Institute of Chest Diseases, Karachi, Pakistan for further management and Pleurodesis. Conclusion: Bilateral spontaneous pneumothorax is medical and surgical emergency, diagnosis is thru clinical history, examination of chest and X-ray chest. Prompt diagnosis and management with chest intubation bilaterally and supportive treatment may decrease the morbidity in these critical cases.

自发性气胸单孔胸腔镜手术后肺部并发症预测模型的构建

目的:探讨自发性气胸单孔胸腔镜手术后肺部并发症预测模型的构建。方法:选取2021年5月至2022年5月行单孔胸腔镜手术的106例自发性气胸患者,根据术后是否发生肺部并发症将患者分为并发症组(n=22)与无并发症组(n=84)。对两组患者临床资料进行单因素与多因素分析,筛选出影响术后肺部并发症的危险因素,并构建列线图预测模型。结果:并发症组患者年龄、吸烟史、合并肺部疾病、胸膜粘连严重、肺大疱数量、术后24 h疼痛分级、术中出血量高于无并发症组,术前白蛋白水平低于无并发症组。多因素Logistic回归分析结果显示,年龄≥50岁(OR=1.240,95%CI=1.064~1.445)、合并肺部疾病(OR=26.154,95%CI=1.224~558.648)、胸膜粘连严重(OR=23.289,95%CI=2.940~184.520)、肺大疱数量>2个(OR=2.878,95%CI=1.787~4.633)是影响术后肺部并发症的独立危险因素(P<0.05)。根据以上危险因素建立预测模型预测术后肺部并发症的受试者工作特征曲线下面积为0.82(95%CI=0.756~0.874),敏感度与特异度分别为82.33%与65.47%。结论:年龄、合并肺部疾病、胸膜粘连严重、肺大疱数量是影响自发性气胸单孔胸腔镜手术后肺部并发症的独立危险因素,根据其构建的列线图预测模型对术后肺部并发症的发生风险具有较好的预测价值。

不同导管胸膜腔置管闭式引流治疗自发性气胸疗效比较

目的:比较不同导管胸膜腔置管闭式引流治疗自发性气胸疗效。方法:选取新乡市第一人民医院2018年9月至2023年9月收治的90例自发性气胸患者作为研究对象,应用随机数字表法将其分为三组,即中心静脉导管组、胸腔引流管组与三腔气囊导尿管组,各组均为30例。所有患者均采取胸膜腔置管闭式引流术进行治疗,三组患者分别采取中心静脉导管、胸腔引流管和三腔气囊导尿管进行引流。比较三组患者临床疗效,置管时疼痛发生率、置管时出血量、二次置管率与调整引流管率,平均切口大小、肺复张时间、置管时间、住院时间,术后疼痛程度,术后并发症发生情况。结果:胸腔引流管组和三腔气囊导尿管组的总有效率高于中心静脉导管组;中心静脉导管组和三腔气囊导尿管组患者置管时疼痛发生率、二次置管率与调整引流管率以及置管时出血量均明显低于胸腔引流管组;中心静脉导管组患者平均切口大小明显短于三腔气囊导尿管组和胸腔引流管组,且三腔气囊导尿管组短于胸腔引流管组;术后1 d、3 d、5 d,中心静脉导管组和三腔气囊导尿管组患者的视觉模拟评分法(VAS)评分明显低于胸腔引流管组,中心静脉导管组和三腔气囊导尿管组切口感染、肺水肿/皮下气肿、胸膜反应发生率明显低于胸腔引流管组;差异均具有统计学意义(P<0.05)。结论:采取胸腔引流管与三腔气囊导尿管进行胸膜腔置管闭式引流治疗自发性气胸疗效优于中心静脉导管,而应用中心静脉导管和三腔气囊导尿管患者置管时疼痛发生率较低,能够降低二次置管率、创伤性较低,降低术后疼痛程度,减少并发症发生率。

基于数据挖掘技术研究中医治疗自发性气胸的组方配伍规律

目的:研究中医治疗自发性气胸的组方用药规律,为临床治疗提供有益参考。方法:收集中国知网、维普中文期刊服务平台、万方数据库、中国生物医学数据库等4个数据库建库至2023年2月28日发表的中医治疗自发性气胸的相关文献,采用中医传承辅助平台V2.5统计用药频次、常用药对及药物组合,采用关联规则、改进的互信息法、复杂系统熵聚类分析对药物关联规则及核心药物组合进行分析,采用无监督的熵层次聚类进行新处方分析。结果:共筛选出符合条件的方剂187首,涉及中药237味,使用频次≥10的中药有甘草、黄芪、茯苓、五味子、白术等55味,主要由补虚药、化痰止咳平喘药、活血化瘀药、理气药、清热药及利水渗湿药组成;由关联规则分析得到白术-茯苓、甘草-茯苓、黄芪-当归、党参-黄芪、麦冬-甘草等24种高频药物组合,其中甘草、黄芪、茯苓、白术、五味子、当归等是关联网络的核心;熵聚类分析得到药物核心组合30个、潜在的新处方15个。结论:中医治疗自发性气胸围绕虚、痰、瘀、郁的特点,以益气护肺、祛痰止咳、活血化瘀、行气利水等为核心治法,体现了肺、肝、脾、肾同治及虚实兼顾的治疗思路。