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老年患者继发性气胸的电视辅助胸腔镜手术外科治疗结果及住院时间延长的危险因素

Surgical results of video-assisted thoracic surgery and risk factors for prolonged hospitalization for secondary pneumothorax in elderly patients.

作者信息

Matsuoka Katsunari, Kuroda Ayumi, Kang Angyoung, Imanishi Naoko, Nagai Shinjiro, Ueda Mitsuhiro, Miyamoto Yoshihiro

机构信息

Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Hyogo, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2013;19(1):18-23. doi: 10.5761/atcs.oa.12.01909. Epub 2012 Aug 20.

Abstract

BACKGROUND

The treatment of secondary pneumothorax in elderly patients is difficult because of underlying diffuse lung injury and complex medical comorbidities. Such patients still have high morbidity rates, resulting in longer periods of hospitalization.

METHODS

To examine the results of video-assisted thoracic surgery for elderly patients (aged 70 years or over) with secondary pneumothorax and investigate the risk factors for hospital stay longer than 7 days, we retrospectively analyzed the results obtained in such patients at our institution.

RESULTS

From among 73 patients who entered this study, 7 patients (9.6%) had postoperative complications. Video-assisted thoracic surgery could treat pneumothorax in 71 patients, except for the 2 who died in hospital. The median postoperative drainage and hospital stay periods were 2 days (1-40 days) and 5 days (2-51 days). Patients with interstitial pneumonitis, pulmonary infection and low total protein or sodium levels were the risk factors for hospital stay longer than 7 days.

CONCLUSIONS

VATS is a safe and effective procedure for secondary pneumothorax in elderly patients. Patients with interstitial pneumonitis, pulmonary infection, and hyponutrition state were the risk factors for postoperative hospital stay prolongation.

摘要

背景

老年患者继发性气胸的治疗较为困难,因为存在潜在的弥漫性肺损伤和复杂的内科合并症。这类患者的发病率仍然很高,导致住院时间延长。

方法

为了研究电视辅助胸腔镜手术(VATS)治疗老年(70岁及以上)继发性气胸患者的效果,并调查住院时间超过7天的危险因素,我们回顾性分析了我院此类患者的治疗结果。

结果

在纳入本研究的73例患者中,7例(9.6%)出现术后并发症。除2例在医院死亡的患者外,电视辅助胸腔镜手术可治疗71例气胸患者。术后引流时间和住院时间的中位数分别为2天(1 - 40天)和5天(2 - 51天)。间质性肺炎、肺部感染以及总蛋白或血钠水平低的患者是住院时间超过7天的危险因素。

结论

电视辅助胸腔镜手术对于老年患者继发性气胸是一种安全有效的治疗方法。间质性肺炎、肺部感染和营养不良状态是术后住院时间延长的危险因素。

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