老年慢性阻塞性肺气肿合并自发性气胸的治疗

摘要

目的：总结探讨老年慢性阻塞性肺气肿（ COPD）合并自发性气胸的治疗经验。方法对67例慢性阻塞性肺气肿合并自发性气胸的老年患者的临床资料进行回顾性分析。结果本组67例，61例行胸腔闭式引流术，4例保守治疗，2例胸腔穿刺抽气，其中43例行电视胸腔镜手术（ VATS）或胸腔镜辅助小切口（ VAMT）肺大疱切除术，3例中转开胸手术。痊愈63例，死亡2例，2例患者自动放弃治疗。结论老年慢性阻塞性肺气肿合并自发性气胸患者，应根据具体情况选择不同的治疗方法，如果手术适应证选择恰当、术前准备充分，应积极采取胸腔镜手术治疗，能取得满意的临床疗效。%Objective To investigate the treatment experience of aged chronic obstructive pulmonary disease ( COPD) com⁃bined with spontaneous pneumothorax . Methods A retrospective analysis was performed with clinical data of 67 cases of the aged chronic obstructive pulmonary disease combined with spontaneous pneumothorax. Results A total of 67 patients were enrolled in our study, 61 patients of whom were treated by thoracic close drainage, 4 patients by conservative treatment and other 2 patients by thora⁃centesis. Meanwhile, pulmonary bulla resection by video⁃assisted thoracoscopic surgery ( VATS) or video⁃assisted minithoraeotomy ( VAMT) was performed on 43 patients, however, 3 patients of whom received open operation during the surgical period. There were 63 patients recovered, while 2 patients died and 2 patients quitted because of specific reasons. Conclusion The treatment options for aged chronic obstructive pulmonary disease combined with spontaneous pneumothorax should be selected individually. Video⁃assisted thoracoscopic surgery is an ideal option for specific patients with appropriate indications and better preparations.