老年自发性气胸临床特点分析

目的 探讨老年自发性气胸的临床特点、治疗与转归。方法 对比分析109例老年自发性气胸和112例中青年自发性气胸的临床资料，包括临床表现、气胸类型、肺压缩程度、原有基础疾病、诱因、误诊情况、治疗与转归，并进行统计学分析。结果 老年组患者与中青年组患者的临床表现，除咳嗽外，差异均有显著性意义（P〈0．05）；老年组原有肺部疾病比例与中青年组比较差异有显著性意义（P〈0．05）；两组患者的诱发因素除用力排便外，差异均有显著性意义（P〈0．05）；两组患者的误诊率、治愈率、平均肺复张时间间差异亦均有显著性意义（P〈0．05）。结论 老年自发性气胸患者大多有肺部基础疾病，以张力性气胸和交通性气胸多见，临床特征不典型，以突然或进行性加重的气促、喘息、呼吸困难多见，治疗多需排气减压术，肺复张时间长，预后较差。

Analysis of the Elderly Patients with Spontaneous Pneumothorax

Objective To study the clinic features,treatment and outcome of spontaneous pneumothorax in elderly.Methods The clinical data 109 elderly patients and of 112 younger patients with spontaneous pneumothorax,including clinical manifestation,types of pneumothorax,lung compression level,original diseases,inducing factors,conditions of misdiagnosis,treatment and outcome were comparatively analyzed in statistics.Results There was a significant difference in clinical manifestation,except for cough,between the elderly group and younger group(P<0.05);there was a significant difference in percentage of original diseases between the two groups(P<0.05);there was a significant difference in inducing factor,except for exertion in defecation,between the two groups(P<0.05);there were significant differences in misdiagnosis rate,cure rate and average lung expansion time between the two groups(P<0.05).Conclusion Most of the elderly patients with spontaneous pneumothorax had base diseases of lungs which were mainly tension and open pneumothorax,clinically with no typical features;the symptoms most seen were suddenly or progressively deteriorated polypnea,gasp and dyspnea.In treatment exsufflation decompression was needed,the average time of lung expansion was longer,and the prognosis was not good.