Riquet M, Le Pimpec-Barthes F, Debrosse D, Houel R, Hubsch J P, Manac'h D, Saab M, Debesse B
Service de Chirurgie Thoracique, Hôpital Laennec, Paris.
Rev Mal Respir. 1995;12(2):151-60.
The occurrence of a pneumothorax occurring as a complication of AIDS is a poor prognostic sign. We have undertaken a review of 26 patients admitted to hospital for a pneumothorax of whom 25 were admitted for therapy: five resolved under simple drainage; twenty required a pleurodesis which was performed on thirteen under video thoracoscopy: these were recurrent pneumothoraces and were bilateral in half the patients; all had failed under simple drainage. The hospital mortality was 30%; the follow-up was unusually long in the majority of cases and only 20% had a simple follow-up. The analysis of this population showed that the results were not tied to the proposed treatment but to the state of the disease and to the pre-existence of pulmonary lesions most often in relation to pneumocystis. Video thoracoscopy enables one to inspect the lung and to resect the diseased area at the origin of the air leak. The technique also enables the pleurodesis to be achieved and a pleural or lung biopsy to be obtained in a relative non-invasive fashion.
作为艾滋病并发症出现的气胸是预后不良的征兆。我们对26例因气胸入院的患者进行了回顾，其中25例入院接受治疗：5例经单纯引流后痊愈；20例需要进行胸膜固定术，其中13例在电视胸腔镜下进行：这些均为复发性气胸，半数患者为双侧气胸；所有患者经单纯引流均无效。医院死亡率为30%；大多数病例的随访时间异常长，只有20%进行了简单随访。对这组人群的分析表明，结果并非取决于所采用的治疗方法，而是取决于疾病状态以及肺部病变的预先存在情况，这些病变大多与肺孢子菌有关。电视胸腔镜能够检查肺部并切除漏气源头的病变区域。该技术还能够以相对无创的方式实现胸膜固定术并获取胸膜或肺活检样本。
