Nüesch K, Stuby K, Medici T C
Schweiz Med Wochenschr. 1978 Feb 25;108(8):313-4.
There is much divergence of opinion as to how spontaneous pneumothorax should be treated or even whether it should be treated at all. Nowadays this benign pulmonary disease is primarily treated surgically, although conservative management of spontaneous pneumothorax seems to provide equally good results, as already indicated in 1932 by KJAERGAARD. Histories and clinical findings for 87 patients who were initially treated for spontaneous pneumothorax were reviewed and the factors responsible for the choice of treatment established. The mean age of the patients was 34 years, and 60% of the patients were below 30. Males predominated over females by 8:1. No coexisting pulmonary diseases were found in 80% of the patients. 54 patients were treated conservatively (no treatment except antitussives or analgesics). 46 conservatively treated patients had pneumothorax for the first time; 4 patients each had pneumothorax for the second or third time or more. 46 of 66 patients with idiopathic pneumothorax received no treatment, whereas 12 of 20 patients who had coexisting pulmonary diseases were treated surgically. The pneumothorax did not recur in 30 of 37 patients treated conservatively and observed for 1--15 years. These data suggest that conservative management is as effective as surgical treatment in uncomplicated spontaneous pneumothorax.
关于如何治疗自发性气胸，甚至是否应该对其进行治疗，存在着很多意见分歧。如今，这种良性肺部疾病主要采用手术治疗，尽管自发性气胸的保守治疗似乎也能取得同样好的效果，正如1932年凯尔gaard所指出的那样。回顾了87例最初接受自发性气胸治疗的患者的病史和临床检查结果，并确定了决定治疗方式的因素。患者的平均年龄为34岁，60%的患者年龄在30岁以下。男性与女性的比例为8:1。80%的患者没有并存的肺部疾病。54例患者接受了保守治疗（除止咳药或镇痛药外未进行其他治疗）。46例接受保守治疗的患者是首次发生气胸；4例患者分别是第二次、第三次或更多次发生气胸。66例特发性气胸患者中有46例未接受治疗，而20例并存肺部疾病的患者中有12例接受了手术治疗。37例接受保守治疗并观察1至15年的患者中，气胸未复发。这些数据表明，在无并发症的自发性气胸中，保守治疗与手术治疗同样有效。
