National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Respir Care. 2011 Mar;56(3):298-302. doi: 10.4187/respcare.00695. Epub 2011 Jan 21.
Pneumothorax is a well known complication of pulmonary tuberculosis (TB), particularly in patients with advanced TB.
At our national TB-referral hospital, we compared the medical records of 53 TB patients with pneumothorax and 106 TB patients without pneumothorax, seen in 2003 to 2008. We analyzed data on demographics; TB type (smear-positive, smear-negative, extrapulmonary); patient type (new patient, relapse, treatment default, treatment failure); clinical and radiological manifestations; surgeries; and outcomes.
Of the 53 pneumothorax patients, 34 (64%) were male. The pneumothorax group's mean age was 34 y (range 14-76 y). Thirty-six (68%) of the pneumothorax patients were new TB cases (ie, TB undiagnosed before they presented with pneumothorax). Pneumothorax was not significantly associated with sex, smoking, or drug use. Pneumothorax was significantly more common in patients < 30 years old (P < .001). In terms of radiological manifestations, 20 pneumothorax patients (38%) had cavitary lesions, and pulmonary infiltration and effusion were present in 19 (36%) and 17 (32%) patients, respectively. Cavitary lesion was significantly more common among the pneumothorax patients (P = .006). Overall, 47 (89%) of the pneumothorax patients were relieved with chest-tube insertion; the other pneumothorax patients were only observed.
In patients < 30 years old or with cavitary lesions, worsening of the patient's respiratory condition should prompt consideration of pneumothorax.
气胸是肺结核（TB）的一种常见并发症，尤其在晚期 TB 患者中更为常见。
在我们的国家结核病转诊医院，我们比较了 2003 年至 2008 年间收治的 53 例气胸 TB 患者和 106 例无气胸 TB 患者的病历。我们分析了人口统计学数据；TB 类型（涂片阳性、涂片阴性、肺外）；患者类型（新患者、复发、治疗失败、治疗失败）；临床表现和影像学表现；手术；以及结局。
53 例气胸患者中，34 例（64%）为男性。气胸组的平均年龄为 34 岁（范围 14-76 岁）。36 例（68%）气胸患者为新发 TB 病例（即在出现气胸之前未被诊断为 TB）。气胸与性别、吸烟或药物使用无关。气胸在年龄<30 岁的患者中更为常见（P<0.001）。在影像学表现方面，20 例气胸患者（38%）有空洞病变，19 例（36%）和 17 例（32%）患者分别存在肺部浸润和胸腔积液。气胸患者中空洞病变更为常见（P=0.006）。总体而言，47 例（89%）气胸患者通过胸腔引流得到缓解；其他气胸患者仅接受观察。
对于年龄<30 岁或有空洞病变的患者，若患者呼吸状况恶化，应考虑气胸的可能性。
