儿童原发性自发性气胸的临床表现：78 例患者分析。

Clinical manifestations of primary spontaneous pneumothorax in pediatric patients: an analysis of 78 patients.

机构信息

Division of Pediatrics, Cheng Ching General Hospital, Taichung, Taiwan.

出版信息

Pediatr Neonatol. 2011 Jun;52(3):150-4. doi: 10.1016/j.pedneo.2011.03.006. Epub 2011 May 31.

DOI:10.1016/j.pedneo.2011.03.006

PMID:21703557

Abstract

BACKGROUND

The aims of this investigation were to explore primary spontaneous pneumothorax (PSP) in pediatric patients and to evaluate the clinical manifestations and outcomes of the PSP.

METHODS

Seventy-eight patients diagnosed with PSP between January 2004 and December 2009 was retrospectively studied. The clinical data on demographics, diagnostic imaging, therapeutic approach, and outcomes were collected and analyzed.

RESULTS

The sex ratio of 78 PSP patients was 7.7:1 (male:female=69:9), and the age distribution concentrated between 15 years and 18 years (66 patients, 84.6%). The most common presenting symptom was chest pain (69 patients, 88.5%). The average body mass index was 18.2±1.6 (n=66). Autumn was the more likely attack season for PSP in this study (p=0.005). Twenty-eight patients (35.9%) had tension pneumothorax. Only nine (11.5%) patients had a past history of cigarette smoking. All 21 outpatients received supportive treatment. Out of 57 inpatients, 10 (17.5%) received oxygen therapy, 39 (68.4%) received closed-tube drainage, and 6 (10.5%) received video-assisted thoracoscopic surgery. Apical bleb and subpleural bullae formation were common pathological findings (21 patients, 91.3%). Twenty-four (42.1%) patients experienced a second attack, and six (10.5%) patients had a third attack.

CONCLUSION

Pediatric PSP occurred mainly in boys of the late teenage group with lower body mass index. Autumn was the most likely attack season. There was only a small portion of the patients who smoked. There was no evidence to find a correlation between smoking and pediatric PSP attacks. Length of stay was shorter in supportive treatment and closed-tube drainage patients than that in video-assisted thoracoscopic surgery-treated patients. The outcomes were satisfactory.

摘要

背景

本研究旨在探讨小儿原发性自发性气胸（PSP），并评估 PSP 的临床表现和结局。

方法

回顾性分析 2004 年 1 月至 2009 年 12 月期间诊断为 PSP 的 78 例患者。收集并分析了人口统计学、诊断影像学、治疗方法和结局的临床数据。

结果

78 例 PSP 患者中男女性别比为 7.7:1（男：女=69:9），年龄分布集中在 15 至 18 岁（66 例，84.6%）。最常见的首发症状为胸痛（69 例，88.5%）。平均体重指数为 18.2±1.6（n=66）。本研究中，秋季更易发生 PSP 发作（p=0.005）。28 例（35.9%）患者为张力性气胸。仅有 9 例（11.5%）患者有吸烟史。21 例门诊患者均接受支持治疗。57 例住院患者中，10 例（17.5%）接受吸氧治疗，39 例（68.4%）接受闭式引流，6 例（10.5%）接受电视胸腔镜手术。尖部肺大疱和胸膜下肺大疱形成是常见的病理表现（21 例，91.3%）。24 例（42.1%）患者出现第二次发作，6 例（10.5%）患者出现第三次发作。