天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
6期
639-642,707
,共5页
张莹%贾玮%李月川%李海娜
張瑩%賈瑋%李月川%李海娜
장형%가위%리월천%리해나
自发性气胸%患肺压缩形态%胸腔闭式引流%胸膜粘连%外围型%不规则型
自髮性氣胸%患肺壓縮形態%胸腔閉式引流%胸膜粘連%外圍型%不規則型
자발성기흉%환폐압축형태%흉강폐식인류%흉막점련%외위형%불규칙형
spontaneous pneumothorax%lung compressed form%closed thoracic drainage%pleural adhesion%peripheral shape%irregular shape
目的：探讨自发性气胸患肺压缩形态对治疗方法选择的指导价值。方法依据胸部X线后前位平片所示的患肺压缩形态将219例自发性气胸患者分为外围型（127例）、不规则型（92例）2组。观察患肺压缩形态与既往行胸腔闭式引流术次数、胸腔闭式引流术7d治愈率、胸腔闭式引流术治愈时间及外科手术中所见胸膜粘连的关系。结果行0、1和≥2次胸腔闭式引流术不规则型的发生率分别为11.71%（13/111）、57.89%（33/57）和90.19%（46/51），不规则型的发生率随既往胸腔闭式引流次数的增加而升高（χ2=96.339，P<0.01）。外围型、不规则型患者行胸腔闭式引流术分别治愈94、30例，不规则型胸腔闭式引流术7 d治愈率低于外围型[36.7%(11/30) vs 90.4%(85/94)，χ2=37.596，P<0.01]，胸腔闭式引流术治愈时间高于外围型[d：10.10±4.87 vs 4.00±2.07，t=9.806，P<0.01]。2组有95例行手术治疗，不规则型胸膜粘连发生率高于外围型[91.9%（57/62）vs 18.2%（6/33），χ2=52.445，P<0.01]。结论患肺压缩形态为外围型的患者行胸腔闭式引流治疗成功率高，为不规则型宜行外科手术治疗。
目的：探討自髮性氣胸患肺壓縮形態對治療方法選擇的指導價值。方法依據胸部X線後前位平片所示的患肺壓縮形態將219例自髮性氣胸患者分為外圍型（127例）、不規則型（92例）2組。觀察患肺壓縮形態與既往行胸腔閉式引流術次數、胸腔閉式引流術7d治愈率、胸腔閉式引流術治愈時間及外科手術中所見胸膜粘連的關繫。結果行0、1和≥2次胸腔閉式引流術不規則型的髮生率分彆為11.71%（13/111）、57.89%（33/57）和90.19%（46/51），不規則型的髮生率隨既往胸腔閉式引流次數的增加而升高（χ2=96.339，P<0.01）。外圍型、不規則型患者行胸腔閉式引流術分彆治愈94、30例，不規則型胸腔閉式引流術7 d治愈率低于外圍型[36.7%(11/30) vs 90.4%(85/94)，χ2=37.596，P<0.01]，胸腔閉式引流術治愈時間高于外圍型[d：10.10±4.87 vs 4.00±2.07，t=9.806，P<0.01]。2組有95例行手術治療，不規則型胸膜粘連髮生率高于外圍型[91.9%（57/62）vs 18.2%（6/33），χ2=52.445，P<0.01]。結論患肺壓縮形態為外圍型的患者行胸腔閉式引流治療成功率高，為不規則型宜行外科手術治療。
목적：탐토자발성기흉환폐압축형태대치료방법선택적지도개치。방법의거흉부X선후전위평편소시적환폐압축형태장219례자발성기흉환자분위외위형（127례）、불규칙형（92례）2조。관찰환폐압축형태여기왕행흉강폐식인류술차수、흉강폐식인류술7d치유솔、흉강폐식인류술치유시간급외과수술중소견흉막점련적관계。결과행0、1화≥2차흉강폐식인류술불규칙형적발생솔분별위11.71%（13/111）、57.89%（33/57）화90.19%（46/51），불규칙형적발생솔수기왕흉강폐식인류차수적증가이승고（χ2=96.339，P<0.01）。외위형、불규칙형환자행흉강폐식인류술분별치유94、30례，불규칙형흉강폐식인류술7 d치유솔저우외위형[36.7%(11/30) vs 90.4%(85/94)，χ2=37.596，P<0.01]，흉강폐식인류술치유시간고우외위형[d：10.10±4.87 vs 4.00±2.07，t=9.806，P<0.01]。2조유95례행수술치료，불규칙형흉막점련발생솔고우외위형[91.9%（57/62）vs 18.2%（6/33），χ2=52.445，P<0.01]。결론환폐압축형태위외위형적환자행흉강폐식인류치료성공솔고，위불규칙형의행외과수술치료。
Objective To evaluate the guiding values of different lung compressed forms in the choice of the treat?ment of spontaneous pneumothorax. Methods Based on lung compressed forms on anterior-posterior chest X-ray , a total of 219 spontaneous pneumothorax patients were divided into the periphery shape group (n=127) and irregular shape group (n=92). We observe the relationship between lung compressed form with the times of previous closed thoracic drainage,the cure rate of closed chest drain at the 7th day,length that closed thoracic drainage cure pneumothorax and the incidences of the surgical pleural adhesion. Results We found that the incidence of irregular lung compression in 0, 1 and 2 times of re?ceiving previous drainage were 11.71%(13/111), 57.89%(22/57) and 90.19%(46/51) respectively. Its incidence increased with the times of previous closed chest drain (χ2=96.339, P<0.01). In total, 94 patients (85 of which were cured until the 7th day) and 30 patients (11 of which were cured until the 7th day) were cured using close chest drain in peripheral shape and ir?regular shape group. And the 7th day cure rate is lower in irregular group than that in the peripheral shape. [36.7%(11/30) vs 90.4%(85/94),χ2=37.596, P<0.01]. What’s more, patients in irregular group need longer time to cure pneumothorax than patients in peripheral shape did [d:10.1±4.87 vs 4.00±2.07, t=9.806, P<0.01]. Among the 95 patients who underwent surgi?cal treatment in both groups, the incidence of pleural adhesion is higher in irregular shape group than that in peripheral shape group [91.9%(57/62)vs18.2%(6/33),χ2=52.445, P<0.01]. Conclusion The 7th day cure rate in patients with pe?ripheral shape lung compressed form is higher than patients in irregular lung compressed form using closed chest drain with fewer incidence of pleural adhesion and shorter cure time. Those with irregular lung compression is more appropriate for sur?gical treatment.
