慢性阻塞性肺病并发自发性气胸58例临床观察  

Clinical observation of 58 cases of chronic obstruction pulmonary diseases (COPO) complicated with spontaneous pneumothorax

作　　者：张栋才[1] 

机构地区：[1]安徽省蚌埠市第一人民医院内科,233000

出　　处：《淮海医药》1999年第B09期7-8,共2页Journal of Huaihai Medicine

摘　　要：目的 了解慢性阻塞性肺病（COPD）并发自发性气胸的临床特点,找出易误诊的原因、诊断及治疗要点。方法 所有的病例均拍摄X线胸片,必要时加拍左、右侧位胸片或X线多轴透视或胸部CT检查。测定肺压缩的程度,并用人工气胸器测压确定气胸的类型。确诊后立即给予胸穿抽气或胸腔闭式引流治疗。结果 COPD并发气胸患者年龄较大,临床表现不典型,容易误诊为原发病加重,误诊率为22.4％,大部分病例（75.9％）需行胸腔闭式引流治疗,病死率较高（5.2％）。结论 对经积极治疗无效的COPD患者,要想到是否并发气胸,要常规拍摄胸片或X线多轴透视,一旦确诊为气胸,多需紧急胸穿抽气或胸腔闭式引流治疗。Objective To research the clinical characteristics of COPD complicated with spontaneous pneumothorax, the causes of misdiagnosis and the main points of diagnosis and treatment. Methods All cases were diagnosed with complet chest films or CT, estimated the degree of lung suppression and classified. As soon as the diagnosis was made drainage manergement started either by simple aspiration or closed drainage. Rusults Since patients were aged and clinical features were atypic, the rate of misdiagnosis and mortality were 22. 4% and 5. 2% respectively. Conclusion When patients with COPD are refractory to energetic treatment, spontaneous pneumothorax should be considered.

关 键 词：慢性阻塞性肺病 并发症 自发性气胸 误诊原因 治疗 

分 类 号：R563[医药卫生—呼吸系统] R561.4[医药卫生—内科学]