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不同年龄自发性气胸患者的临床特征与预后比较:一项两年随访研究

Comparison of Clinical Characteristics and Prognosis Among Spontaneous Pneumothorax Patients of Different Ages: A Two-Year Follow-Up Study.

作者信息

Wang Ting, Bai Yang

机构信息

Department of Respiratory Medicine, Xi'an People's Hospital (Xi'an No.4 hospital), Xi'an, 710004, People's Republic of China.

Department of Medical Ultrasonics, Xi'an People's Hospital (Xi'an No.4 hospital), Xi'an, 710004, People's Republic of China.

出版信息

Int J Gen Med. 2024 Dec 6;17:5849-5858. doi: 10.2147/IJGM.S397474. eCollection 2024.

Abstract

PURPOSE

Spontaneous pneumothorax (SP), which is usually characterized by sudden chest pain and shortness of breath, can occur at any age. In this study, patients with SP across various age groups were enrolled, and their clinical features and prognoses were compared.

PATIENTS AND METHODS

The patients were divided into three groups: neonates (n=52), adolescents/adults (n=76), and elderly (n=70). All patients were followed up for two years. The patients' clinical characteristics, treatments, laboratory indicators on admission, and symptoms over two years were collected and compared. Additionally, as most patients in the elderly group had chronic obstructive pulmonary disease (COPD), data about patients' lung function tests and medication were also analyzed.

RESULTS

Compared with adolescents/adults (6.45±0.24 days), patients with SP in the neonate and elderly groups had more comorbidities, resulting in a longer hospital stay (13.85±0.34 days in neonates and 9.50±0.36 days in the elderly). The main comorbidities in the latter two groups were neonatal asphyxia (17/52) and COPD (48/70), respectively. During the two-year follow-up period, elderly patients with SP had more long-term respiratory symptoms, including coughing, expectoration, and dyspnea, than those in the other two groups. Analysis of the main subgroup (48 COPD cases) in the elderly group revealed that, in the two years after the occurrence of pneumothorax, acute exacerbation times increased; group E cases/(A+B) cases were 4/44, 4/44, 5/43, and 7/41 every 6 months respectively. Additionally, lung function indexes (FEV1, FVC, MEF) decreased.

CONCLUSION

Compared to adolescents and adults, newborn and elderly patients with SP are more prone to comorbid lung diseases and longer hospitalization times. The prognosis of neonates is significantly better than the other groups. Increased frequency of acute exacerbations and a deteriorating trend in pulmonary function were observed in patients with COPD after discharge.

摘要

目的

自发性气胸(SP)通常表现为突发胸痛和呼吸急促,可发生于任何年龄。在本研究中,纳入了不同年龄组的SP患者,并比较了他们的临床特征和预后。

患者与方法

患者分为三组:新生儿(n = 52)、青少年/成人(n = 76)和老年人(n = 70)。所有患者均随访两年。收集并比较患者的临床特征、治疗方法、入院时的实验室指标以及两年内的症状。此外,由于老年组中的大多数患者患有慢性阻塞性肺疾病(COPD),因此还分析了患者的肺功能测试和用药数据。

结果

与青少年/成人(6.45±0.24天)相比,新生儿组和老年组的SP患者合并症更多,导致住院时间更长(新生儿为13.85±0.34天,老年人为9.50±0.36天)。后两组的主要合并症分别为新生儿窒息(17/52)和COPD(48/70)。在两年的随访期内,老年SP患者比其他两组有更多的长期呼吸道症状,包括咳嗽、咳痰和呼吸困难。对老年组主要亚组(48例COPD病例)的分析显示,气胸发生后的两年内,急性加重次数增加;E组病例/(A+B)组病例每6个月分别为4/44、4/44、5/43和7/41。此外,肺功能指标(FEV1、FVC、MEF)下降。

结论

与青少年和成人相比,新生儿和老年SP患者更容易合并肺部疾病,住院时间更长。新生儿的预后明显优于其他组。出院后COPD患者急性加重频率增加,肺功能呈恶化趋势。

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