原发性自发性气胸对侧复发的相关因素研究  

Factors related to contralateral recurrence of primary spontaneous Pneumothorax

作　　者：杨鹏[1] 李庆志[1] 周笑[2] 郭德庆[1] 马宪友[1] 祝沪军[1] 

机构地区：[1]大庆油田总医院胸外科,大庆163000 [2]大庆油田总医院肿瘤科,大庆163000

出　　处：《国际外科学杂志》2012年第9期597-599,共3页International Journal of Surgery

摘　　要：目的探讨影响原发性自发性气胸对侧复发的相关因素，为防止原发性自发性气胸对侧复发提供依据。方法回顾分析2006年1月-2011年12月收治的203例原发性白发性气胸患者的临床资料和随访结果，全组患者中位随访43个月。结果203例原发性自发性气胸患者共发生气胸241次，其中有27例发生对侧复发，对侧复发的平均时间为20．19个月。原发性自发性气胸对侧复发组与未对侧复发组相比较，患者具有年龄小（P〈0．05）、低体重（P〈0．05）和低体重指数（P〈0．01）的临床特征。所有原发性自发性气胸对侧复发的患者均行手术治疗，术中均可见肺大疱。3例患者出现双侧气胸，行同期双侧电视胸腔镜手术。结论原发性自发性气胸对侧复发多发生于低体重和低体质指数的年轻患者，对于此类患者术前可先行肺部高分辨率CT检查，如发现对侧肺存在肺大疱，可以考虑同期行双侧电视胸腔镜手术来防止原发性自发性气胸对侧复发。Objective To investigate the factors associated with contralateral recurrence of primary spontaneous pneumothorax And provide reference for how to prevent primary spontaneous Pneumothrorax with Contralateral recur-rence. Methods From January 2006 to December 2011, the clinical follow-up data of 203 patients with primary spontaneous pneumothorax were reviewed. The median follow-up time was 43 months. Results Two hundred and three patients developed 241 recurrences, among which 27 patients had contralateral recurrences. The average time of eontralateral recurrence was 20. 19 months. Patients with contralateral recurrence of primary spontaneous pneumothorax had smaller age（ P 〈 0.05 ） , lower body weight （ P 〈 0.05 ） and lower body mass index （ P 〈 0.01 ）. All patients with contralateral recurrence of primary spontaneous pneumothorax received surgical treatment and were found bullae during surgery. Three patients had unilateral recmrences of pnemnothorax during follow up, with single-stage bilateral video-assisted thoracoscopic surgery for bilateral primary spontaneous pneumothorax. Conclusions Contralateral recurrence of primary spontaneous pneumothorax is more common in patients with small age, low body weight and low body mass index. These patients could perform high-resolution computerized tomo-graphic scan of the lung before surgery. Single-stage bilateral video-assisted thoracoscopic surgery may be consid-ered for these patients with contralateral bullae on high-resolution computerized tomographic scan of the lung to pre- vent contralateral recurrence of primary spontaneous pneumothorax.

关 键 词：气胸 复发 胸腔镜检查 

分 类 号：R655[医药卫生—外科学]