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自发性气胸是呼吸科常见急诊之一,而慢性阻塞性肺病(COPD)并发气胸发病率逐年增加,且并发症多、病情严重、病死率高、及时诊断处理可化险为夷、否则可危及生命.现收集我院1985年以来收治的COPD并发气胸38例与同期收治特发性气胸95例对照分析如下.1 临床资料1.1 一般资料 COPD组38例,其中男36例,女2例.年龄38～78岁,平均59岁,50岁以上占84.2%.基础病慢性支气管炎、肺气肿33例,支气管哮喘5例.其中合并肺结核5例,肺心病10例,肺脑2例.特发性气胸组95例,其中男90例,女5例.年龄18～58岁.平均28岁,40岁以上占 7.4%.两组比较年龄差异非常显著(P<0.01).1.2 诱因 COPD组以肺部感染为最多,特发性气胸组以用力或剧咳为多.两组比较差异非常显著(P<0.01).COPD组肺部感染22例(57.8%),用力或剧咳13例(34.2%).无诱因3例(7.9%).特发性气胸组肺部感染10例(10.5%).用力或剧咳60例(63.2%).无诱因25例(26.3%).1.3 气胸类型及肺压缩程度,见表1.
Spontaneous pneumothorax is one of the common emergency department of respiratory medicine, and the incidence of pneumoconiosis complicated by chronic obstructive pulmonary disease (COPD) is increasing year by year. And the complication is high, the condition is serious, the case fatality rate is high, and timely diagnosis and treatment can be saved. Otherwise, it will be life-threatening. Collection of our hospital since 1985 admitted to COPD in 38 cases of pneumothorax and concomitant treatment of idiopathic pneumothorax 95 cases were analyzed as follows.1 Clinical data 1.1 General Information COPD group of 38 patients, 36 males and 2 females.Ages 38 to 78 Years old, average 59 years old, accounting for 84.2% over the age of 50. Chronic bronchitis, bronchiectasis in 33 cases, bronchial asthma in 5. Among them combined pulmonary tuberculosis in 5 cases, pulmonary heart disease in 10 cases, pulmonary brain in 2. Idiopathic pneumothorax Group 95 cases, including 90 males and 5 females.Ages ranging from 18 to 58 years.Average 28 years old, over the age of 40 accounted for 7.4% .The age difference between the two groups is very significant (P <0.01) .1.2 Induced COPD group of lung (P <0.01) .COPD group had pulmonary infection in 22 (57.8%) cases, 13 cases (34.2%) with or without severe cough, ), No incentive in 3 cases (7.9%) .In the idiopathic pneumothorax group, 10 cases (10.5%) had pulmonary infection, 60 cases (63.2%) were forced or cough or 25 cases (26.3%) without any incentive. 1.3 pneumothorax type and degree of lung compression, see Table 1.