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目的 探讨老年人自发性气胸的临床特点,并对误诊原因进行分析,提高对老年人自发性气胸的认识和诊断水平。方法 对1999年1月~2004年1月住院老年人自发性气胸患者33 例进行临床分析。结果 老年人自发性气胸多有肺部基础疾病,呼吸困难明显,但肺压缩程度低,以张力性气胸、局限性气胸多见,容易出现各种并发症,病死率高。结论 老年气胸多继发于其他肺病(COPD,肺结核等),病情重,体征不典型,容易误诊,及早诊断和进行胸腔闭式引流是降低病死率、并发症的关键。
Objective To investigate the clinical features of spontaneous pneumothorax in the elderly and to analyze the causes of misdiagnosis and to improve the understanding and diagnosis of spontaneous pneumothorax in the elderly. Methods From January 1999 to January 2004, 33 cases of spontaneous pneumothorax in hospitalized elderly patients were analyzed. Results The elderly spontaneous pneumothorax mostly pulmonary diseases, respiratory difficulties, but the degree of lung compression is low, with tension pneumothorax, limitations of pneumothorax more common, prone to various complications, high mortality. Conclusions The pneumothorax in the elderly is mostly secondary to other lung diseases (COPD, tuberculosis, etc.). The patients with severe pneumoconiosis and signs are not typical and easily misdiagnosed. Early diagnosis and closed thoracic drainage are the key to reduce the mortality and complications.