结核病与肺部健康杂志 ›› 2014, Vol. 3 ›› Issue (3): 152-156.doi: 10.3969/j.issn.2095-3755.2014.03.003

• 论著 • 上一篇    下一篇

自发性气胸合并肺结核49例治疗经验

夏照华, 宁新忠, 王海江, 邓群益, 李国保, 王辉, 邓国防   

  1. 518000 深圳市第三人民医院外二科(夏照华、宁新忠、王海江),肺科(邓群益、李国保、邓国防),感染科(王辉)
  • 收稿日期:2014-06-03 出版日期:2014-06-20 发布日期:2014-06-20
  • 通信作者: 夏照华,Email:daoren_000113@126.com

The treatment experience of spontaneous pneumothorax complicated with pulmonary tuberculosis in 49 patients

XIA Zhao-hua, NING Xin-zhong, WANG Hai-jiang, DENG Qun-yi, LI Guo-bao, WANG Hui,DENG Guo-fang   

  1. Second Department of Surgery,the Third People’s Hospital of Shenzhen,Shenzhen 518000,China
  • Received:2014-06-03 Online:2014-06-20 Published:2014-06-20

摘要: 目的 总结自发性气胸(SP)合并肺结核的治疗经验。方法回顾性分析深圳市第三人民医院2008年7月至2013年7月期间TB合并继发性自发性气胸(SSP)患者49例,收集相关临床资料。结果在该项研究期间,在我院共治疗SP患者850例,其中有TB导致SSP共计49例;与此同时,共计有2179例活动性肺结核患者得到治疗。在这49例TB合并SSP患者中,21例在诊断为SSP时为活动性TB,28例为非活动性TB。所有患者中有41例(83.7%)需要留置1次胸管,有4例(8.1%)需留置2次胸管,有2例(4.1%)需留置3次胸管;有2例(4.1%)暂未留置胸管予以观察,期间SSP逐渐吸收好转。留置胸管时间为(12.5±11.1)d。气胸复发需留置2根胸管6例(18.3%),其中1例(4.1%)发生在对侧,5例(8.1%)需要手术治疗。14例(28.6%)因胸腔闭式引流术后持续漏气和气胸复发行胸腔镜手术;有3例(21.4%)产生术后并发症:持续漏气>5d 1例,肺炎1例,手术伤口感染1例。住院时间为(15.02±13.07)d。结论胸腔闭式引流术是一种治疗TB合并SSP的常规方法,预后较好,需要再次留置胸管或手术的可能性较小。

Abstract: Objective We summarized the treatment experience of spontaneous pneumothorax (SP) in patients diagnosed with TB.Methods We retrospectively collected and analyzed the medical records of 49 patients with TB and secondary SP treated in our hospital between July, 2008 and July, 2013.Results During the study period, a total of 850 patients with SP were treated in our hospital, 49 of whom had SP secondary to TB. Also during this period, 2179 cases of active TB were treated. Of the 49 cases with secondary SP, 21 presented with active TB at the moment of producing SSP and 28 had inactive TB. With regard to pleural drainage (PD) as a treatment for SSP, forty one (83.7%) patients needed one PD, four (8.1%) needed two, and two (4.1%) needed three. A decision to wait was made in two patients (4.1%), and the evolution of their SSP was favourable during their stay. The mean stay for PD was (12.5±11.1) days. The treatment for these recurrences was to perform another PD in 6 (18.3%) cases, 1 (4.1%)of them occurred contra laterally, and 5 (8.1%)patients needed surgery. VATS was performed in 14 (28.6%) patients for persistent air leakage after PD and relapses, There were 3 (21.4%) posto-perative complications: persistent air leaks for >5 days in 1 case, pneumonia in 1 case and surgical wound infection in 1. The hospital length of stay was (15.02±13.07) days.Conclusion The treatment of SP secondary to TB with PD is usually a sound response, with a good general prognosis and a low percentage of cases that require another PD and surgical treatment.