Sousa Cristiana, Neves Joao, Sa Nuno, Goncalves Fabienne, Oliveira Julio, Reis Ernestina
Medicine Service, Unit D, Santo Antonio Hospital, Oporto Hospital Center, Porto, Portugal.
J Clin Med Res. 2011 May 19;3(3):111-7. doi: 10.4021/jocmr560w.
Spontaneous pneumothorax (SP) is defined by the presence of air in the pleural space without history of trauma. It is classified as secondary if coexisting with underlying pulmonary disease. Its an entity with considerable incidence and treatment particularities which give reason for a reflection on the subject. We present a 5-year casuistry, characterizing the SP epidemiology, clinical presentation, investigation and therapeutic choices.
Sixty-six patients were included in the study, corresponding to 93 episodes of SP.
We have found male predominance and the mean age was 34.5 years old. In 60.6% of cases there was history of tobacco use; 36.4% of cases were classified as secondary; 30.1% of patients with secondary SP and 21.7% with primary SP recurred; 89.2% had an acute presentation. The most frequent initial symptom was chest pain (90.3%) and 81.7% had diminished breath sounds. In 17.3% it was documented a physical strain associated. We did not identify statistically significant association between the SP occurrence and the variation of the atmospheric pressure, on the first day of symptoms. In 12.9% of episodes the initial treatment option was observation. In most of the episodes the lung totally expanded. However, in 29.1% of the episodes surgical treatment was needed.
Our results are similar to the literature. Some clinical records are incomplete, demanding the implementation of rules to improve knowledge about this matter.
Spontaneous pneumothorax; Primary spontaneous pneumothorax; Secondary spontaneous pneumothorax; Epidemiology.
自发性气胸(SP)是指在无创伤史的情况下胸膜腔内出现气体。如果与潜在的肺部疾病共存,则分类为继发性。它是一种发病率和治疗特殊性都相当高的疾病,值得对该主题进行反思。我们呈现了一个5年的病例集,描述了SP的流行病学、临床表现、检查和治疗选择。
66例患者纳入研究,对应93次SP发作。
我们发现男性居多,平均年龄为34.5岁。60.6%的病例有吸烟史;36.4%的病例被分类为继发性;继发性SP患者中有30.1%复发,原发性SP患者中有21.7%复发;89.2%有急性表现。最常见的初始症状是胸痛(90.3%),81.7%有呼吸音减弱。17.3%记录到有相关的体力活动。在症状出现的第一天,我们未发现SP发生与大气压力变化之间有统计学意义的关联。12.9%的发作初始治疗选择是观察。在大多数发作中肺完全复张。然而,29.1%的发作需要手术治疗。
我们的结果与文献相似。一些临床记录不完整,需要实施相关规则以提高对此问题的认识。
自发性气胸;原发性自发性气胸;继发性自发性气胸;流行病学