COPD并发气胸患者肺复张影响因素的分析

发布时间：2018-05-15 13:00

  本文选题：慢性阻塞性肺疾病 + 自发性继发性气胸　； 参考：《天津医科大学》2012年硕士论文

【摘要】：目的：探讨影响COPD并发气胸患肺复张的因素。 方法：通过参考胸腔气体压力分析标准、气胸压缩范围计算方法及CAT评分标准,观察不同气胸类型、患肺压缩范围、发病至临床干预时间及CAT评分对患肺复张的影响。 结果：1、纳入111例COPD继发性气胸患者中,94例患者到达观察终点,其中张力性气胸(47例)、闭合性气胸(27例)、交通性气胸(20例)的患肺复张时间分别为91.91±45.68h、56.89±27.56h、120.00±46.07h,三者比较有差异(G=13.800,P0.01)。2、47例张力性气胸患者行胸腔闭式引流术后24h内完全复张2例(4.26%),72h内完全复张21例(44.68%),7d内复张22例(46.810,6),10d内复张2例(4.26%)：27例闭合性气胸患者行胸腔闭式引流术后24h完全复张7例(25.93%),72h内完全复张17例(62.96%),7d内完全复张3例(11.11%)；20例交通性气胸患者行胸腔闭式引流术后24h内完全复张0例,72h内完全复张5例(25.000%),7d内完全复张13例(65.00%),1Od内完全复张2例(10.00%)。到达观察终点的94例患者中,24h内完全复张9例(9.57%),3d内完全复张52例(55.32%),7d内完全复张90例(95.74%),10d内复张4例(4.26%)。3、根据患肺压缩范围分为≤30%亚组、30%亚组,张力性气胸两亚组的患肺复张时间分别为：84.80±54.16h、98.52±41.08h (t=-0.988, P0.05);闭合性气胸两亚组患肺复张时间分别为：64.00±27.71h、51.43±28.02h (t=1.146, P0.05);交通性气胸两亚组患肺复张时间分别为：111.00±36.14h、126.00±52.31h (t=-0.704, P0.05)。4、根据发病至临床干预时间分为≤72小时亚组、72小时亚组,张力性气胸两亚组患肺复张时间分别为：102.18±50.27h、70.29±28.96h (t=2.214, P0.05);闭合性气胸两亚组患肺复张时间分别为：72.00±28.95h.44.80±20.01h (t=2.884, P0.05)交通性气胸两亚组患肺复张时间分别为：135.43±46.70h、84.00±13.15h (t=2.616, P0.05)。5、根据患者CAT评分分为≤20分亚组、20分亚组,张力性气胸两亚组患肺复张时间分别为：73.09±33.52t、109.92±50.95h (t=-2.884, P0.05)闭合性气胸两亚组患肺复张时间分别为：46.50±23.95h、72.00±26.29h (t=-2.613, P0.05):交通性气胸两亚组患肺复张时间分别为：85.33±27.13h、148.36±38.43h(t=-4.140, P0.05)。 结论：慢性阻塞性肺疾病继发气胸患者中,闭合性气胸患肺完全复张时间短于张力性气胸及交通性气胸,张力性气胸患肺完全复张时间短于交通性气胸；发病至就诊行胸腔闭式引流时间越长患肺复张时间越短,反之患肺复张时间越长；CAT评分越低患肺复张时间越短,反之患肺复张时间越长；患肺复张时间与气胸压缩范围无关。
[Abstract]:Objective: to investigate the factors influencing pulmonary retensions in COPD complicated with pneumothorax. Methods: the effects of different types of pneumothorax, the range of lung compression, the time of clinical intervention and the CAT score on the reexpansion of lung were observed by referring to the standard of chest gas pressure analysis, the calculation method of pneumothorax compression range and the CAT score. Results of the 111 COPD secondary pneumothorax patients, 94 reached the observation end point. Among them, 47 cases of tension pneumothorax, 27 cases of closed pneumothorax, 20 cases of traffic pneumothorax, respectively.) the time of reexpansion of lung was 91.91 卤45.68 h, 56.89 卤27.56 h, 120.00 卤46.07 h, respectively. There was a difference among the three groups. There were differences among the three groups. There were two cases with tension pneumothorax within 24 hours after closed drainage. Within 7 days, 22 cases (46.81010) and 2 cases (4.26: 27) with closed pneumothorax were treated with thoracic closed pneumothorax within 24 hours, 7 cases (7 cases) with complete retraction within 25.932h, 17 cases with complete retraction within 7 days (62.96%), 3 cases (11.1111) with traffic pneumothorax within 7 days. Within 24 hours after closed drainage of thoracic cavity, 0 cases were completely restored within 72 hours, 5 cases were completely restored within 25.000 days, 13 cases were completely restored within 7 days, 65.00% and 2 cases were completely restored within 1 Od. Among the 94 patients who reached the end of observation, 9 cases (9. 57%) were completely restored within 24 h and 52 cases (52 cases) were completely restored within 3 d within 55.32% / 7 d, 90 cases (95. 74%) within 10 days, 4 cases (4. 26%) were divided into 30% subgroup (鈮，

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