老年COPD并发自发性气胸72例临床探讨

目的：探讨老年慢性阻塞性肺病（COPD）患者并发自发性气胸的特点及诊疗方法.方法：对2006～2009年收住我院的72例老年慢性阻塞性肺病并发自发性气胸的临床资料进行回顾性分析.结果：手术治疗47例（65.3%）,治愈67例（93.1%）,自动出院3例,死亡2例.结论：老年COPD并发自发性气胸起病隐匿,表现不典型,病情进展快,常常会导致严重的心肺功能衰竭,病死率高.由于单纯抽气治疗效果不佳,宜尽早行胸腔闭式引流排气,胸腔镜下肺大疱切除术.

Clinical investigation of treating 72 cases of spontaneous pneumothorax of COPD senile

Objective： To investigate the clinical characteristics of spontaneous pneumothorax of senile with chronic obstructive pulmonary disease. Methods： Retrospective study on the records of spontaneous pneumothorax in 72 elder patients with chronic obstructive pulmonary disease; their characteristics of them were compared. Resialts： The acute and chronic onset of the spontaneous pneumo-thorax in the elder patients were 19 cases and 33 respectively; 47 cases were received VATS, 67 cases of them were cured （93.1%）, 2 died （2.8%）. Conclusion： The onset of spontaneous pneumothorax in senile with chronic obstructive pulmonary disease is insidious; the disease is lack of typical clinical feature, with various concomitant diseases, with higher motality. Closed chest tube drainage or VATS should be performed as early as possible because of the unsatisfactory effect of simple evacuation.