Ribichini P, Solaini L, Montanari M C, Amigoni A, Piccinini E
I Divisione Chirurgica, Ospedale S. Maria delle Croci, Ravenna.
Minerva Chir. 1990 Sep 15;45(17):1097-9.
Following an analysis of current treatment strategies for spontaneous pneumothorax and their surrounding controversies, the paper reports the Authors' personal experience. From 1 January 1984 to 31 December 1989 a total of 76 cases of spontaneous pneumothorax were treated, of which 3 were bilateral. The M:F ratio was 9:1 and the age of patients ranged between 16 and 77 years (mean age 39.2); 22 cases were relapses (27.8%). Conservative therapy was used in 12 cases (15.1%); pleural drainage was introduced in 54 cases (68.3%) for a mean of 7.5 days. Fourteen thoracotomies were performed in 13 patients (10.4%): bullectomy was performed 10 times with stapler, whereas pleurodesis was obtained in 9 cases using pleural abrasion and in 5 cases using apical pleurectomy plus pleural abrasion. Axillary thoracotomy at the 5th space was most commonly used. No major complications were observed during the postoperative period and, in spite of the minimum follow-up of 3 months, no cases of relapse were observed in operated patients.
在分析了自发性气胸的当前治疗策略及其相关争议后,本文报告了作者的个人经验。从1984年1月1日至1989年12月31日,共治疗了76例自发性气胸患者,其中3例为双侧气胸。男女比例为9:1,患者年龄在16岁至77岁之间(平均年龄39.2岁);22例为复发患者(27.8%)。12例(15.1%)采用保守治疗;54例(68.3%)进行胸腔引流,平均引流7.5天。13例患者(10.4%)接受了14次开胸手术:10次使用吻合器进行肺大疱切除术,9例通过胸膜摩擦实现胸膜固定术,5例采用肺尖胸膜切除术加胸膜摩擦实现胸膜固定术。最常采用的是在第5肋间进行腋中线开胸手术。术后未观察到重大并发症,尽管最短随访时间为3个月,但手术患者中未观察到复发病例。