早期排气与延迟排气对自发性气胸预后的影响.docVIP

早期排气与延迟排气对原发性自发性气胸疗效的差异比较 吴立平 甄永强 杨晓明 刘婷 滕琳 杨艺 【摘要】：目的：探讨早期排气与延迟排气对原发性自发性气胸疗效的影响,比较近期疗效和并发症。方法：对264例性自发性气胸随机分为早期排气组142例（3天内）和延迟排气组122例（第7天）治疗，观察近期疗效住院时间、失败率，随访2年观察远期疗效复发次数、胸膜粘连等指标。结果：住院时间：早期排气组与延迟排气组分别为18±6天，6±2天 ；早期排气组，气胸量在20-50%者51中有44例第一次抽气后气胸量增加改为胸腔插管引流;气胸量大于50%行插管引流98例,12例持续漏气转胸外科手术。延迟排气组122例中有例81一次将气体抽尽，41例初次抽气出现咳嗽/呼吸困难加重，次日全部将气体抽尽，无气胸加重/复张性肺水肿的发生。无失败需要转外科者。两组比较近期疗效有差异显著性。2年内随访例数243例，早期排气组随访128例，延迟排气组115例。复发：延迟排气组5例；早期排气组29例；经外科手术者全部无复发。两者比较有显著差异。胸片显示胸膜粘连：早期排气组与延迟排气组分别为79例和0例， 两者比较有显著差异。结论：干预时间早晚影响预后，延迟排气治疗原发自发性气胸安全、创伤小、缩短住院时间，胸膜粘连和复发率低。 关键词： 原发性自发性气胸；排气 ；复发 Comparison of the influence on exhausting air early vs delayed in spontaneous pneumothorax Wuliping zhengyongqiang yangxiaoming liuting tenling yangyi department of Respiratory, Weifang’s people hospital, shangdong 261041,China abstract objective to study the influence on exhausting air early vs delayed in spontaneous pneumothorax. The present prospective study was designed to evaluate the efficacy and complications. Methods 242 patients with primary spontaneous pneumothorax randomly allocated to early (＜72 hours) 作者单位：261041山东省潍坊市人民医院呼吸科 通信作者：吴立平，Email:wfwlp98@ mobilephonesgroup (n 142) or delayed (＞6 days) exhaust air group (n 122),investigated the recent success rates, average time in hospital， recurrences rates , pleura adhesion rates. results average time in hospital :early group and delayed group respectively was 18?d vs 6?d .In early group ,size of 者：pneumothorax among 20-50% , 51 subjects were aspirated and 44 of 51 subjects’ size were increased after first aspiration, whereafter were subsequently treated by intercostal drainage. size of pneumothorax more than 50% ,98 patients by intercostal drainage treated.12 of 142 patients with persistence leak air transferred to surgery .In delayed group , In all out of 122 aspirations were successful at the first time. There were significant differences between the two groups in recent successful rate. 29 of the 128 patients