肺大疱患者自发性气胸临床特点及复发影响因素分析

摘要

Objective To analyze pulmonary bulla status and influence factors of spontaneous pneumothorax patients with recurrence . Methods Selecting 48 cases confirmed by computed tomography ( CT) in pulmonary bulla of spontaneous pneumothorax patients as the re-search object in the hospital from Mar .2010 to Feb.2014, the clinical data of the patients were retrospectively analyzed , and the patients with onset time, age, sex, smoking history, the triggers, merge existing lung disease, extrapulmonary basis summarizes clinical data , such as analysis of pulmonary bulla related influence factors of spontaneous pneumothorax patients with recurrence .Results The result showed that the postoperative recurrence rate is high and spontaneous pneumothorax patients with pulmonary bulla pneumothorax onset symptoms of chest distress.All kinds of merging existing inside and outside of pulmonary disease is one of the important factors influencing the recur -rence of pneumothorax .Conclusion Correctly evaluating patients surgery tolerance ability and timely surgical treatment can reduce the probability of spontaneous pneumothorax occurs or recurrence , and it is also an effective measure to improve the quality of life .%目的：分析肺大疱患者自发性气胸复发现状和影响因素。方法选取我院2010－03～2014－02间收治的48例经CT证实存在肺大疱的自发性气胸患者为研究对象，对本组患者的临床资料进行回顾性分析。所有患者首次发病确诊后均卧床休息，常规给予吸氧、止咳等基础治疗，合并肺部感染者加用抗生素控制感染。肺压缩面积＜20％者5例，气胸均自行吸收；肺压缩面积＞20％者43例行胸腔闭式引流术。仍有9例经以上治疗效果不佳，行手术治疗。结果对所有患者随访至2014年8月，随访时间均在半年以上。共有14例患者气胸复发，气胸的复发率为29．2％。其中6例为1次复发，4例为2次复发，3例为3次复发，1例为4次复发。复发的患者中，最终有2例接受胸腔镜手术，1例行开胸手术。认为肺大疱患者自发性气胸复发率高，气胸发作胸闷症状多见，各种合并存在的肺内外基础病，是气胸复发的重要影响因素。结论对复发性气胸患者，正确评估患者手术耐受能力，及时外科手术处理，可降低自发性气胸发生或复发的概率，也是改善患者生活质量的有效措施。