Jadoul D, Petropoulos P, Hahnloser P
Acta Chir Belg. 1976 Jul;75(4):416-26.
This study reports the treatment of 192 consecutive cases of spontaneous pneumothorax observed in 99 patients. Relapses are frequent, but it could be shown that their number can be reduced by more aggressive therapy. Conservative treatment led to 99 % of relapses, whereas they were reduced to 32 % by continuous pleural suction, as shown in 76 cases. Pleurodesis with glucose 40 % or 50 % solution followed by continuous suction for 7 days, is advertised by the authors for every first episode of spontaneous pneumothorax. Under this treatment relapses were observed in only 19 % of the cases. If however after this treatment a recurrent pneumothorax occurs, thoracotomy has to be considered for parietal pleurectomy and occasional resection of emphysematous bullae. This procedure was successfull in all 13 cases where it had been applied.
本研究报告了对99例患者中观察到的192例连续自发性气胸病例的治疗情况。复发很常见,但可以证明,通过更积极的治疗可以减少复发次数。保守治疗导致99%的复发,而如76例所示,持续胸腔吸引可将复发率降至32%。作者建议对自发性气胸的每一首次发作采用40%或50%葡萄糖溶液进行胸膜固定术,随后持续吸引7天。在这种治疗下,仅19%的病例观察到复发。然而,如果在这种治疗后发生复发性气胸,则必须考虑进行开胸手术以切除壁层胸膜并偶尔切除肺大疱。该手术在所有应用的13例病例中均获成功。