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目的对慢性阻塞性肺疾病并发自发性气胸进行回顾性分析,认识此病的临床特点并减少漏诊、误诊,降低死亡率。方法抽调望江县医院近8年来收治的慢性阻塞性肺疾病并发自发性气胸87例之病历,就其相关临床资料进行归纳统计。结果 45例(51.72%)根据症状、体征做出初步诊断并经X线检查证实;28例(32.18%)临床症状、体征不典型经胸部X线或CT确诊;14例﹙16.09%﹚因病情危重没有行X线或CT检查者,漏诊、误诊时间4～48 h,其中死亡8例(9.19%)。结论患者因慢性阻塞性肺疾病影响,临床表现不典型及病情危重不能及时检查是漏诊、误诊的主要原因。漏诊、误诊,延误治疗导致病死率高。合并基础疾病依次为慢性支气管炎、支气管哮喘、肺结核以及所致的肺心病。诱发因素为呼吸道感染、用力排便、咳嗽、打喷嚏。临床主要表现为咳嗽、呼吸困难突然或逐渐加重。
Objective To retrospectively analyze the clinical features of the patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax and to reduce the missed diagnosis, misdiagnosis and reduce the mortality rate. Methods The data of 87 cases with chronic obstructive pulmonary disease admitted to Wangjiang Hospital for the past eight years were collected and analyzed, and their clinical data were summarized. Results Twenty-five patients (51.72%) were diagnosed according to their symptoms and signs and confirmed by X-ray examination. The clinical symptoms and signs of atypical cases were confirmed by X-ray or CT in 28 cases (16.18%), Critically without X-ray or CT examination, missed diagnosis, misdiagnosis time 4 ~ 48 h, of which 8 patients died (9.19%). Conclusion Patients with chronic obstructive pulmonary disease, atypical clinical manifestations and critical illness can not be timely examination is the main reason for missed diagnosis, misdiagnosis. Misdiagnosis, misdiagnosis, delayed treatment lead to high mortality. The basic diseases combined were chronic bronchitis, bronchial asthma, tuberculosis and pulmonary heart disease. Induced by respiratory infections, forced defecation, cough, sneezing. The main clinical manifestations of cough, difficulty breathing suddenly or gradually increased.