老年慢性阻塞性肺病合并自发性气胸39例分析

目的探讨老年慢性阻塞性肺病患者合并自发性气胸的临床特点。方法回顾性分析我院自2003年4月～2009年7月收治的39例老年慢性阻塞性肺病合并自发性气胸患者的临床资料，并与35例同期非老年慢性阻塞性肺病合并自发性气胸患者的资料进行比较分析。结果老年组急性起病12例，缓慢起病27例，首诊误诊18例，误诊率46．15％，死亡4例，死亡率10．26％。结论老年慢性阻塞性肺病合并自发性气胸起病隐匿，症状不典型，易误诊漏诊，病死率高，且单纯抽气治疗效果不佳，应尽早行胸腔闭式引流治疗。

Analysis of 39 Cases of Chronic Obstructive Pulmonary Disease Complicated with Spontaneous Pneumothorax

Objective To investigate the clinical features of chronic obstructive pulmonary disease complicated with spontaneous pneumothorax. Methods 39 cases of chronic obstructive pulmonary disease complicated with spontaneous pneumothorax and 35 other patients were treated in our hospital from April 2003 to July 2009 were analyzed retrospectively, characteristics of them were compared. Results The acute and chronic onset of the spontaneous pneumothorax in the elder patients were 12 cases and 27 respectively;18 cases of them were misdiagnosed in the first diagnosis （46.15%）,4 died （10.26%）. Conclusion Chronic obstructive pulmonary disease complicated with spontaneous pneumothorax not only has slow-onset and no typical clinical features hut also has high misdiagnosis rate and mortality rate. Closed chest tube drainage should be performed as early as possible because of the unsatisfactory effect of simple evacuation.