目的探讨自发性气胸的治疗原则。方法回顾性分析自发性气胸患者 418例的治疗方法 ;保守治疗 18例 ,胸腔穿刺抽气 5 5例 ,胸腔闭式引流 2 72例 ,手术治疗 73例。结果治愈 412例 ,死亡 6例。结论继发性气胸应尽早行胸腔闭式引流术 ,不提倡胸腔负压吸引及经胸管行胸膜固定术 ,胸腔抽气只宜作为诊断手段或闭合性少量气胸的治疗 ,特发性气胸宜尽早手术治疗。 Objective To investigate the treatment principle of spontaneous pneumothorax. Methods The clinical data of 418 patients with spontaneous pneumothorax were retrospectively analyzed. Among them, conservative treatment was performed in 18 cases, thoracentesis was performed in 55 cases, closed pleural drainage was performed in 72 cases, and surgery was performed in 73 cases. Results of 412 cases were cured, 6 died. Conclusions Secondary pneumothorax should be closed thoracic drainage as early as possible. Thoracic vacuum suction and pleurodesis without thoracotomy should be advocated. Thorax aspiration should only be used as a diagnostic method or a small amount of closed pneumothorax. Idiopathic pneumothorax Surgical treatment as soon as possible.