肺大疱病的年龄分布及临床特点探讨  

Clinical characters and age distribution of pulmonary bulla

作　　者：邹卫[1] 丁一冰[2] 刘政呈[1] 王朝[1] 潘宴青[1] 曹磊[1] 高千[2] 易龙[2] 

机构地区：[1]东南大学医学院附属南京胸科医院胸心外科,江苏210029 [2]南京大学医学院江苏省分子医学重点实验室,南京210093

出　　处：《中华肺部疾病杂志（电子版）》2016年第3期267-270,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金资助项目(81170002/H0102);南京市科委;南京市卫生局重点项目(ZKX11030)

摘　　要：目的探讨不同年龄肺大疱自发性气胸患者的临床特征。方法对2007年至2013年1 228例经病理确诊为肺大疱的患者进行回顾性分析。结果性别上差异明显（男女之比为7.4︰1）,年龄分布特点明显,20岁以下及20-25岁两组（青少年组）发病数明显占高位,分别占30.0%及15.6%（368、192/1228）,其中18、19、20岁又是青少年组中患病发病的高峰,分别占该组的27.4%、25.0%及21.7%;男女比例高达15︰1;且男青少年有身材瘦高,头围小,肩宽,胸部扁平,肌肉及脂肪不发达,四肢细长等体征,首发症状多为自发性气胸,无体检发现肺大疱病例,主要临床症状有胸闷、胸痛、咳嗽,无明显呼吸困难,CT可见不同程度气胸,血气分析正常,既往有对侧气胸病史占24%。25岁以上年龄组发病有明显下降。60岁以上老年组患者常见合并肺部其他疾病,体型瘦弱,临床起病急,易有张力性气胸、皮下气肿及不同类型的呼吸衰竭,故围手术期并发症明显增多。结论青少年组与老年组在临床特征上的差异与肺大疱发病原因不同有关,其病理特点亦有不同,故临床特征、手术中所见、围手术期处理及预后等方面均有明显不同。Objective To investigate the clinical features of primary spontaneous pneumothorax（ PSP）caused by pulmonary bulla and classify into groups according to age. Methods It was studied retrospectively that 1 228 cases of PSP diagnosed by pathology from 2007 to 2013. Results There was significant difference in sex（ Male to Female ratio is 7. 4︰1） and age. The incidence was high in all those under twenty years（ 368 / 1228,30.0%） and the age between 20 to 25 years（ 192 / 1 228,15.6%）,highest in patients aged of 18（ 101 /368,27.4%）,19（ 92 / 368,25.0%）,20（ 80 / 368,21.7%）. The incidence rate peaked and started decreasing at the age of 25 and 60. Male adolescent patients are usually tall and thin,they have small head circumference,shoulder width,flat breast,lower developed muscle and fat,slender limbs and other signs. The initial symptoms were chest pain or cough without dyspnea caused by primary thorax,which could be seen in chest computer tomography,no case was found by physical examination. Blood gas was normal. 24% patients had previous history of contralateral pneumothorax. Morbidity in 25 years old age group were significantly lower. 60 years of age or older group of patients were thin and weak,sometimes concurrent with common lung disease.Clinical onset were always acute, the incidence of perioperative complications were significantly higher,including tension pneumothorax,subcutaneous emphysema and respiratory failure. Conclusion There are differences between younger group and elder group in clinical features,operative technique,perioperative management and prognosis due to pathogenic and pathological factors.

关 键 词：肺大疱 自发性气胸 年龄 临床特征 

分 类 号：R563[医药卫生—呼吸系统]