特发性自发性气胸的临床研究

目的了解特发性自发性气胸(PSP)患者的体型特点,随访其治疗效果及肺大疱的诊断率。方法2008年11月—2011年2月收集PSP患者的身高、体质量,计算其体质指数(BMI);根据胸部正侧位片测量胸廓的矢状径、横径;并行胸部CT,随访其治疗效果及肺大疱的诊断率。结果共收集34例PSP患者,多为瘦高体型人群,低BMI(BMI<18.5kg/m2)者24例,占70.59%;男性30例,女性4例,皆无肺部基础疾病。36例患者中,左侧气胸者18例,右侧气胸者14例,双侧气胸者2例。双侧气胸者皆有胸廓畸形,表现为漏斗胸;其余患者多为扁平胸。34例PSP患者胸廓矢状径/横径比值均值为0.39。34例PSP患者胸部高分辨CT发现肺大疱者16例,发现率47.06%;19例胸腔镜手术后确认胸膜下肺大疱者16例,发现率84.21%。结论 PSP患者男性多见,低BMI人群多见,胸廓多呈扁平胸。多数PSP患者肺部病变可见胸膜下肺大疱。

Clinical Analysis of 34 Patients with Primary Spontaneous Pneumothorax

Objective To study the habius of the patients with primary spontaneous pneumothorax(PSP),and follow up their curative effect and the diagnosis rate of bullae.Methods From December 2008 to February 2011,collected the clinical data of each PSP patient,measured the height and weight,then calculated the body mass index(BMI).Measure the antero-posterior diameter(APDb),transthoracic diameter(TTDb)of the thorax based on the standard posterior-anterior and lateral chest film.Each PSP patient took chest computed tomography,and followed up their curative effect and the diagnosis rate of bullae.Results 34 PSP patients were collected.Most of them were tall and thin,24 patients had low BMI(BMI<18.5kg/m2),occupied 70.59%.There were 30 male PSP patients and 4 female patients.All patients had no underlying lung diseases.18 PSP patients had left lateral pneumothorax;14 patients had right lateral pneumothorax;2 patients had bilaterlal pneumothorax.The thorax of the patients with bilateral pneumothorax showed funnel chest,the others showed flat chest.The mean of APDb/TTDb with 34 PSP patients was 0.39.16 patients(occupied 47.06%)had bullae based on high resolution computerized tomography(HRCT);19 patients(occupied 84.21%)under the thorascopic surgery were confirmed to have subpleural bullae.Conclusion Most PSP patients are male and have low BMI,and have flat chest.Most of their lungs have the lesion of subpleural bullae.