25例老年慢性阻塞性肺疾病并发自发性气胸患者临床分析

目的：探讨老年慢性阻塞性肺疾病（COPD）并发自发性气胸患者的临床特点。方法：对25例COPD并发自发性气胸患者的临床资料进行回顾性分析，25例中行胸膜腔穿刺抽气减压9例，胸腔闭式引流13例，3例闭合型气胸患者采取绝对卧床休息后肺复张。结果：老年COPD并发自发性气胸发病诱因多样，典型症状不显著，并发症及复发率高，易发生水、电解质和酸碱平衡紊乱。经治疗24例痊愈，1例死亡。结论：老年COPD并发自发性气胸患者年龄大，体质差，病情重，变化快，必须及早检查确诊，以免漏诊；处理需谨慎，治疗时以综合措施为主，尽早排气，缓解病情，从而降低死亡率。

Clinical analysis of 25 elderly patients with COPD and spontaneous pneumothorax

Objective: To study clinical features of elderly patients with chronic obstructive pulmonary disease(COPD) and spontaneous pneumothorax.Methods: Retropectively analyzed clinical datas of 25 cases with COPD and spontaneous pneumothorax.9 cases had pumping decompression by pleural puncture,13 cases had closed thoracic drainage,and 3 cases with closed pneumothorax had lung recruitment after bed rest.Results: COPD and spontaneous pneumothorax had various causes,high incidence rate of complication,electrolyte imbalance and recurrence,and atypical symptoms.After treatment,24 cases were in cure,while 1 was dead.Conclusions: Elderly patients with COPD and spontaneous pneumothorax have poor physical condition,heavy illness status and fast changes.It is necessary to diagnose as early as possible in order to avoid missed diagnosis.Careful treatment is also important,and comprehensive treatment is main choice.The earlier exhaust is employed,the better patients become.