慢性阻塞性肺疾病并自发性气胸40例临床分析

目的探讨40例慢性阻塞性肺疾病（COPD）并发自发性气胸的诊治情况。方法回顾性分析2005～2009我院收治的40例并发慢性阻塞性肺疾病的自发性气胸患者的临床资料。40例中行胸膜腔穿刺抽气减压18例，胸腔闭式引流15例。7例肺压缩面积〈20％的闭合型气胸患者采用绝对卧床休息及吸氧后肺复张，3例因治疗无效行外科手术治疗治愈。结果诊断此病的最基本最常用的方法为胸部X线检查，不能完全确诊者需行胸部CT进一步检查。确诊后需保守、胸腔闭式引流、胸腔穿刺抽气或外科手术等治疗。结论慢性阻塞性肺疾病并发自发性气胸患者年龄大，体质差，病情重，变化快，漏、误诊率高，易被原发病掩盖，尽快行X线等检查避免漏、误诊，以综合治疗为主，加强吸氧、抗炎、解痉平喘、营养支持等辅助治疗，提高治愈率，降低死亡率。

Clinical analyses of forty cases of chronic obstructive pulmonary disease complicated with spontaneous pneumothorax

Objective To study diagnosis situation of forty cases with chronic obstructive pulmonary and spontaneous pneumothorax.Methods Forty cases( admitted from 2005 to 2009 ) of COPD and spontaneous pneumothorax treated in our hospital was retrospectively analyzed.15 cases had pumping decompression by pleural puncture,18 cases had closed thoracic drainage.7 cases of pulmonary compression area ＜ 20% and closed type of pneummothorax with adsolute bed rest and oxygen inhalation for pulmonary reexpansion,3 cases of sugical operation due to invalid conservative treatment.Results X-ray examination was most fundamental and most important examination diagnosing COPD and spontaneous pneumothorax.The diagnosis could not be completely confirmed,the further examination of chest CT should be per-formed.After the diagnosis,must conservative,chest cavity treatments and so on closed type drainage,chest cavity puncture pumping air or surgical operation.Conclusion Patients with chronic obstructive pulmonary disease and spontaneous pneumothorax have poorphysical condition,heavy illness status and fast change Leaks,the error diagnostic rate to be high,easily by primary affection cover,Line of X and so on inspections avoid leaking,the error diagnostic as soon as possible,by complex therapy primarily,strengthens the oxygen uptake,the anti-inf lammatory,the spasmolysis to breathe heavily evenly,the nutrition support and so on auxiliary treatment,raises the cure rate,cuts the mortality rate.