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目的探讨自发性气胸的病因、诊断、误诊情况及治疗,提高临床医师对自发性气胸的认识和诊断水平。方法收集长葛市人民医院2001年9月至2011年9月收治的自发性气胸患者110例,按年龄分为青壮年组和老年组,进行对比分析。结果老年组显效率为47.5%,青壮年组为80%,45例患者误诊,误诊率为40.9%(青壮年组为31.3%,老年组为44.79%)。结论老年人自发性气胸发病隐袭,多继发于慢性阻塞性肺疾病,呼吸困难明显,胸痛相对较轻,肺压缩程度与复发情况明显高于青壮年自发性气胸患者,病情重但体征不典型,易误诊,肺复张时间亦较青壮年自发性气胸患者长,病死率较高;青壮年自发性气胸多无肺部基础疾病,起病急,以闭合性气胸为主,肺压缩程度重。医务人员必须提高诊断及治疗水平,以期减少误诊率。
Objective To investigate the etiology, diagnosis, misdiagnosis and treatment of spontaneous pneumothorax and to improve clinicians’ understanding and diagnosis of spontaneous pneumothorax. Methods 110 cases of spontaneous pneumothorax were collected from Changge People ’s Hospital from September 2001 to September 2011. The patients were divided into young adults group and old group according to their age, and then analyzed comparatively. Results The effective rate was 47.5% in the elderly group and 80% in the young adult group. Misdiagnosis rate was 40.9% in 45 patients (31.3% in young adults and 44.79% in elderly patients). Conclusions The incidence of spontaneous pneumothorax in the elderly is mainly insidious and often secondary to chronic obstructive pulmonary disease. Obvious dyspnea, chest pain are relatively mild, the degree of pulmonary compression and recurrence are significantly higher than those in young and middle-aged patients with spontaneous pneumothorax. Typical, easy to misdiagnosis, pulmonary recurrent time than young patients with spontaneous pneumothorax longer, higher mortality; idiopathic pneumothorax and more young adults without underlying diseases, acute onset, mainly closed pneumothorax, lung compression weight. Medical staff must raise the level of diagnosis and treatment, with a view to reducing the rate of misdiagnosis.