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自发性气胸不同治疗方法的长期随访

Long-term follow-up of different therapy procedures in spontaneous pneumothorax.

作者信息

Elfeldt R J, Schröder D W, Thies J

机构信息

Klinik für Allgemeine Chirurgie und Thoraxchirurgie Klinikum der Universität, Kiel, Germany.

出版信息

J Cardiovasc Surg (Torino). 1994 Jun;35(3):229-33.

PMID:8040171
Abstract

The objective of this follow-up study was to evaluate the success rate of different therapy procedures in spontaneous pneumothorax. In order to achieve comparable conditions the study was restricted to those patients who were treated because of a first episode (n = 96) in the time between January 1978 and December 1987. Seventy-one were males and 25 females, ratio 3:1. The right side to left side ratio was 3:2. Both sides were affected in 11% (n = 11). All patients received an intercostal tube drainage with a permanent suction. In case of treatment failure thoracoscopy, pleurodesis or an operation were performed. The follow-up investigations was performed in January 1990 thus to further evaluate the outcome of 79 patients (82%) after 2 to 12 years after treatment. Among the patients, 33 patients presented a persistence or an early recurrence, 26 of them were operated during their first stay in hospital. A further 25 patients presented a late recurrence, of whom 14 underwent a later thoracotomy. Consequently the drainage therapy had a failure rate of 61% (n = 58). The frequency of operation was 42% (n = 40). The results after thoracotomy (n = 26) were as follows: slight complications, which did not require surgical treatment occurred in 8% (n = 2). The long-term results after surgical intervention (lung apex resection and/or parietal pleurectomy) were excellent concerning the rate of late recurrences (0% within the follow-up group) and the general condition (96% free or almost free of symptoms) regardless the method of operation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

这项随访研究的目的是评估不同治疗方法治疗自发性气胸的成功率。为了获得可比条件,该研究仅限于1978年1月至1987年12月期间因首次发作接受治疗的患者(n = 96)。其中男性71例,女性25例,比例为3:1。右侧与左侧的比例为3:2。双侧受累的占11%(n = 11)。所有患者均接受肋间置管引流并持续吸引。若治疗失败,则进行胸腔镜检查、胸膜固定术或手术。1990年1月进行了随访调查,以进一步评估79例患者(82%)在治疗后2至12年的结果。在这些患者中,33例出现持续或早期复发,其中26例在首次住院期间接受了手术。另有25例出现晚期复发,其中14例后来接受了开胸手术。因此,引流治疗的失败率为61%(n = 58)。手术频率为42%(n = 40)。开胸手术(n = 26)后的结果如下:8%(n = 2)出现轻微并发症,无需手术治疗。手术干预(肺尖切除和/或壁层胸膜切除术)后的长期结果在晚期复发率(随访组内为0%)和总体状况(96%无症状或几乎无症状)方面均非常好,无论手术方法如何。(摘要截断于250字)

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