老年肺癌并发自发性气胸4例报告并文献复习  

ELDERLY LUNG CANCER COMPLICATED WITH SPONTANEOUS PNEUMOTHORAX -CASE REPORT AND LITERATURE REVIEW

作　　者：马寿康[1] 沙宝康[1] 陈嘉录[2] 林秀婉 

机构地区：[1]华东医院,上海市200040 [2]上海市胸科医院 [3]上海市第六人民医院

出　　处：《老年医学与保健》1999年第3期126-128,共3页Geriatrics & Health Care

摘　　要：目的分析老年肺癌并发自发性气胸的临床特点。方法结合国内外文献复习对4例老年肺癌并发自发性气胸进行回顾性分析。结果肺癌并发气胸临床罕见。气胸发生在肺癌晚期较多。2例气胸先于肺癌,2例同时发现,肺癌并发气胸占同期住院气胸患者的0.99%。气胸压缩肺面积不等,有时伴胸腔积液。常同时有肺不张存在。少数经保守治疗后气胸吸收,肺脏复张。多数虽经抽气,胸腔插管闭式引流或负压吸引等积极治疗,气胸仍不能完全吸收,肺脏不复张或部分复张,且复张速度慢。对可疑对象要进行痰和胸水细胞学检查,或纤支镜检查。必要时作肺穿刺活检、胸膜活检。结论气胸经积极处理长期未愈或肺部异影肿大伴肺不张、血性胸水时应高度警惕,积极检查证实,或排除肺癌。To analyse the clinical characteristics of elderly lung cancer complicated with spontaneous pneumothorax. Methods Retrospective analysis and literature review were carried out with 4 cases of elderly lung cancer complicated with spontaneous pneumothorax. Results Lung cancer complicated with pneumothorax was clinically rare, it occupied only 0.99% of pneumothorax in - patients during the study period. Pneumothorax occurred more at late cancer stage than at early stage. In this paper, pneumothorax occurred before cancer in 2 cases, another 2 cases occurred simultaneously. Only one side of lung was involved in all 4 cases. Lung surface area pressed by pneumothorax varied, sometimes accompanied with pleural fluid and atelectasis. In a few cases, pneumothorax was absorbed after conservative therapy, the lung reinflated. But in most cases, after active treatment with deflation, continued closed drainage or negative pressure suction, pneumothorax still can not be absorbed completely , the lung still deflated or partly and slowly inflated. To those suspected cases, cytological examination of sputum and pleural fluid, fibrobronchoscopy, and needle biopsy of lung or pleura should be considered. Conclusions Pneumothorax after long term active treatment without cure, the shadow in lung grows, complicated with atelectasis and bloody pleural fluid ought to arouse one' s attention to confirm or to deny the lung cancer.

关 键 词：自发性气胸 肺癌 老年 文献复习 并发 肺不张 肺脏 结论 面积 速度 

分 类 号：R734.2[医药卫生—肿瘤] R561.4[医药卫生—临床医学]