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目的:探讨不同年龄段自发性气胸的临床特点及发生原因,提高临床医师对自发性气胸的认识和诊断水平。方法:对我院2001~2008年收治的78例老年人自发性气胸和184例青壮年自发性气胸的临床资料进行对比分析。结果:老年人自发性气胸多继发于肺部基础疾病,呼吸困难明显,胸痛相对较轻,肺压缩程度与复发情况明显高于青壮年自发性气胸患者;青壮年自发性气胸多无肺部基础疾病,起病急,以闭合性气胸为主,肺压缩程度重。结论:老年人自发性气胸发病隐袭,多继发于慢性阻塞性肺疾病,并发症较多,病情重但体征不典型,易误诊,肺复张时间亦较青壮年自发性气胸患者长,病死率较高。提高对老年慢性呼吸系统疾病患者并自发性气胸的警惕性,是早期诊断和降低病死率的关键。
Objective: To investigate the clinical features and causes of spontaneous pneumothorax in different age groups and to improve clinicians’ understanding and diagnosis of spontaneous pneumothorax. Methods: The clinical data of 78 cases of spontaneous pneumothorax and 184 cases of young and middle-aged spontaneous pneumothorax in our hospital from 2001 to 2008 were compared. Results: Most of the elderly spontaneous pneumothorax secondary to pulmonary diseases, obvious breathing difficulties, chest pain is relatively light, the degree of lung compression and recurrence was significantly higher than that of young patients with spontaneous pneumothorax; young spontaneous pneumothorax and no lung Basal disease, acute onset, with closed pneumothorax, lung compression heavy. Conclusions: The incidence of spontaneous pneumothorax in the elderly is mostly insidious and secondary to chronic obstructive pulmonary disease. There are more complications, severe illness but not typical signs, easy misdiagnosis and longer time of pulmonary recurrent than spontaneous pneumothorax in young adults. High mortality. Increasing vigilance in elderly patients with chronic respiratory disease and spontaneous pneumothorax is key to early diagnosis and reduction of mortality.