不同年龄人群单中心自发性气胸的诊治  

Diagnosis and treatment of spontaneous pneumothorax in different age groups from a single center

作　　者：江吕泉[1] 许为民[2] 潘昱辰[2] 郑建[1] 陈建[1] 

机构地区：[1]武警江苏总队医院胸外科,扬州225003 [2]武警江苏总队医院呼吸科,扬州225003

出　　处：《武警医学》2016年第5期440-443,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨不同年龄人群自发性气胸的病因和治疗特点。方法回顾性分析我院2010-01-01至2014-12-31收治的325例自发性气胸患者,按年龄分为青年组和老年组,观察分析患者的发病基础、治疗时间、预后等情况。结果 325例中,闭合性气胸208例,交通性气胸98例,张力性气胸19例。46例胸腔抽气治愈。青年组有明确发病诱因86例,扁平胸57例,行胸腔穿刺抽气成功37例,手术治疗18例;中老年组有明确发病诱因54例,抽气成功9例,胸管留置引流时间及住院平均时间分别为(6.65±10.20)d、(13.20±5.60)d;中老年组手术治疗81例,死亡1例。结论青年人群气胸的发生与扁平胸有关联,发病诱因明确;肺气肿是中老年气胸的主要病因,预防和提前控制中老年慢性阻塞肺气肿感染,是减少中老年人自发性气胸的关键。Objective To study the cause and therapeutic characteristic of spontaneous pneumothorax between youth group（ group B） and middle-senile group（ group A）. Methods Clinical characteristics including pathologic basis,treatment period and prognosis in 325 patients admitted in hospital during Junuary. 1st 2005 to Dec ember 31 st 2014 with spontaneous pneumothorax were reviewed in Jiangsu Provincial Corps Hospital of Chinese People＇s Armed Police Forces. Results There were 325 cases diagnosed as having spontaneous pneumothorax including 208 cases（ 64. 0%） of closed pneumothorax,open pneumothorax（ 98 cases,30. 2%）,tension pneumothorax（ 19 cases,5. 8%）. 46 patients were treated with thoracentesis. Evident inducement was found in 86 cases of group B,57 cases with fliat-chest wall. 37 patients were cured with thoracentesis,18 patients with operation. Evident inducement was found in 54 cases of group A,9 patients were cured with thoracentesis,average drainage days being（ 6. 65 ± 10. 20） d and average length of hospitalization being（ 13. 20 ± 5. 60） d. 81 patients in group A were cured with operation,with one dead in all cases.Conclusions The cause of spontaneous pneumothorax in group B involves flat-chest. This kind of pneumothorax has confirmative inducement. Emphysema is a chief cause of spontaneous pneumothorax in group A. To prevent and control infection of senile chronic obstructive emphysema in advance is the key to reducing the risk of spontaneous pneumothorax in elderly.

关 键 词：自发性气胸 病因学 肺气肿 肺大疱 

分 类 号：R561.4[医药卫生—呼吸系统]