摘要
目的探讨肺结核并发自发性气胸发病、发展、治疗及转归。方法对2001～2010年收治的106例肺结核并发自发性气胸临床表现、X线特点、治疗与预后等进行回顾性分析。结果肺结核并发自发性气胸由于患者基础肺功能状态不良,发病时呼吸困难等症状较重,且常常与气胸的程度不成比例,67例伴严重呼吸困难,其中14例肺压缩面积<20%。而因合并有肺结核、肺气肿、肺大疱、积液、感染等原因,33例体征不典型,部分患者X线胸片不易发现,6例患者通过CT检查确诊局限性气胸。病情发展快,有时很快危及生命,但积极治疗愈后较好,治愈率97.1%。复发率高,治疗疗程长,肺复张时间平均23d,最长47d。部分患者需要长期胸腔闭式引流、持续负压吸引、胸腔注入粘合剂、胸腔镜或手术修补等治疗。结论肺结核因结核病灶及结核病引起的肺气肿、肺大疱等原因易并发自发性气胸,而且临床症状重、疗程长,需积极给予综合治疗。
Objective To discuss the incidence,development,treatment and outcome of pulmonary tuberculosis complicated by spontaneous pneumothorax.Methods X-ray characteristics,treatment and prognosis of one hundred and six cases of pulmonary tuberculosis complicated by spontaneous pneumothorax in our hospital from 2001 to 2010 were analyzed retrospectively.Results Pulmonary tuberculosis complicated with spontaneous pneumothorax due to pulmonary function in patients with base of bad state,when the incidence of respiratory symptoms such as difficulty is heavy,and is often associated with pneumothorax degree disproportionately,67 cases with severe breathing difficulties,of which 14 cases of pulmonary compression area20%.due to combined with pulmonary tuberculosis,pulmonary emphysema,pulmonary bulla,seroma,infection and other causes,33 cases of signs not typical,partial patient chest X-ray is not easy to find,6 patients were diagnosed by CT limitations of pneumothorax.Rapid progression of the disease,sometimes very quickly to endanger life.But aggressive treatment the prognosis is better,the cure rate was 97.1%.The high recurrence rate,long course of treatment,Lung reexpansion average 23d,the longest 47d.some patients require long-term closed thoracic drainage,continuous negative pressure suction,injected into pleural cavity adhesive,thoracoscopy or operation repair and treatment.Conclusion Pulmonary tuberculosis due to tuberculosis and tuberculosis induced emphysema,pulmonary bulla,easily complicated with spontaneous pneumothorax,and severe clinical symptoms,the treatment period is long,need give positive comprehensive treatment.
出处
《当代医学》
2011年第24期6-7,共2页
Contemporary Medicine
关键词
肺结核
自发性气胸
Pulmonary tuberculosis
Spontaneous pneumothorax
