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目的:对老年慢性阻塞性肺气肿并发自发性气胸的特征进行探讨。方法:对本院2009年6月至2011年7月收治的28例老年慢性阻塞性肺气肿合并自发性气胸患者的临床资料进行分析。结果:20例患者患慢性支气管炎,5例患支气管哮喘,3例患肺结核。发病诱因:22例为呼吸道感染剧烈咳嗽,4例为打喷嚏或者用力拉便,2例没有明显诱因。临床表现:缓慢起病18例,急性起病10例。有20例患者出现气管位移、患侧或有局限性气胸体征,8例患者没有出现典型的气胸体征;其中,15例患者属于气胸交通型,9例属于张力型,4例属于闭合型。结果:经治疗,27例患者病情好转出院,1例死亡[1]。结论:老年慢性阻塞性肺气肿并发气胸容易被延迟诊断或者漏诊,在临床观察上应该引起注意,要尽早确定病情,及时治疗。
Objective: To investigate the characteristics of elderly patients with chronic obstructive pulmonary emphysema and spontaneous pneumothorax. Methods: The clinical data of 28 elderly patients with chronic obstructive pulmonary emphysema complicated with spontaneous pneumothorax admitted from June 2009 to July 2011 in our hospital were analyzed. Results: Twenty patients had chronic bronchitis, 5 had bronchial asthma, and 3 had pulmonary tuberculosis. Incentives: 22 cases of severe respiratory tract infection cough, 4 cases of sneezing or forced to pull, 2 cases no obvious incentive. Clinical manifestations: 18 cases of slow onset, acute onset in 10 cases. There were 20 patients with tracheal displacement, ipsilateral or limitations of the pneumothorax signs, 8 patients did not appear typical signs of pneumothorax; of which 15 patients were pneumothorax traffic type, 9 were tension-type, 4 were closed type. Results: After treatment, 27 patients were better discharged and 1 patient died [1]. Conclusion: Chronic obstructive pulmonary emphysema complicated with pneumothorax may be delayed diagnosis or missed diagnosis. It should pay attention to the clinical observation and determine the condition as soon as possible and timely treatment.