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目的探讨老年慢性阻塞性肺气肿并发自发性气胸的发病特点及治疗效果。方法对97例慢性阻塞性肺气种并自发性气胸的临床资料进行回顾性分析,对不同临床表现下COPD并急性气胸的治疗方法进行阐述。结果基础疾病复杂,确诊77例,误诊20例,误诊率20.6%;治愈90例;死亡6例,病死率6.2%;本组病例中以交通型、张力型为多见,共占87.3%,呼吸衰竭38.1%,呼吸性酸中毒32%。1例自动离院。结论慢性阻塞性肺气肿并急性自发性气胸起病隐匿,临床表现不典型,病情严重,误诊率高,进展快、及时诊断和治疗可降低病死率。
Objective To investigate the incidence of chronic obstructive pulmonary empyema complicated by spontaneous pneumothorax and its therapeutic effect. Methods The clinical data of 97 patients with chronic obstructive pulmonary disease and spontaneous pneumothorax were analyzed retrospectively. The treatment of COPD with acute pneumothorax under different clinical manifestations was described. Results The basic diseases were complicated, 77 cases were diagnosed, 20 cases were misdiagnosed, the rate of misdiagnosis was 20.6%. 90 cases were cured, 6 cases died and the case fatality rate was 6.2% .There were 87.3% Respiratory failure 38.1%, respiratory acidosis 32%. 1 patient left the hospital automatically. Conclusions Chronic obstructive pulmonary emphysema with occult onset of acute spontaneous pneumothorax, atypical clinical manifestations, serious illness, high misdiagnosis rate, rapid progression, timely diagnosis and treatment can reduce mortality.