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老年慢性阻塞性肺气肿合并自发性气胸的临床分析 附54例报告 |
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老年慢性阻塞性肺气肿合并自发性气胸的临床分析（附54例报告）
摘要 目的：研究老年慢性阻塞性肺气肿合并自发性气胸的临床特征，探讨老年慢性阻塞性肺气肿患者合并气胸的预防措施及治疗方法。方法：对54例老年慢性阻塞性肺气肿合并自发性气胸患者的病史特征、临床表现、诊断及治疗进行回顾性分析。结果：发病原因主要与合并肺心病、呼吸道感染、阵发性咳嗽等多种因素有关；临床类型以交通型、张力型多见，1／3的患者合并双侧气胸；51例治愈，死亡3例。结论：老年慢性阻塞性肺气肿合并自发性气胸临床表现复杂，病情凶险，误诊率死亡率高，但是早期应用抗生素、避免用力咳嗽、出现肺大泡患者及时手术等可以防止自发性气胸的发生；出现自发性气胸应及早多方位进行胸腔闭式引流，同时应用大剂量敏感抗生素等措施可以降低患者的死亡率。
关键词 肺气肿 气胸慢性阻塞性 引流
Abstract Objective：TO investigate chronicity obstructive pulmonary emphysema with spontaneous aeropleura clinical characteristic,and to approach preventive measure and method of treatment of chronicity obstructive pulmonary emphysema with spontaneous aeropleura.Methods：54 cases of a particular disease patients who were chronicity obstructive pulmonary emphysema were investigated，the case history character,the clinical manifestation，the diagnosis and the treatment were analyzed retrospectively.Results:the onsetting causes were mainly concerned with complic pneumocardial disease，respiratory tract infection，the paroxysmal cough and so on；the clinical types were mainly communication and the tension，1／3 of the patients got the disease of bilateral spontaneous aeropleura；51 patients were cured，3 patients died.Conclusion：Clinical manifestation of chronic obstructive pulmonary emphysema are complex，states of an illness are dangerous，the misdiagnosis rate and mortality rate are high.the spontaneous aeropleura can be prevented by antibiotic used early，avoidance exertion cough，operation to patients with disease of pneumatocele early.the spontaneous aeropleura sould carry on closed drainage of the chest cavity at multi-positions and make use of large dose sensitive antibiotic early,so the mortality rate may be reduced.
Key Words pulmonary emphysema spontaneous aeropleura chronicity obstructive drainage drain
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