Sassoon C S
Pulmonary and Critical Care Section (111P), Department of Veterans Affairs Medical Center, Long Beach, CA 90822, USA.
Curr Opin Pulm Med. 1995 Jul;1(4):331-8.
In the past year, studies on spontaneous pneumothorax have focused on etiology and treatment. Chronic obstructive pulmonary disease remains the most common cause of secondary spontaneous pneumothorax. However, Pneumocystis carinii infections in patients who have AIDS have become the leading cause of spontaneous pneumothorax in a population where its prevalence is high. One of the treatment modalities of spontaneous pneumothorax is tube thoracostomy with the instillation of tetracycline as the sclerosing agent. Tetracycline is no longer available. Fortunately, its derivatives doxycycline and minocycline are equally effective. Talc in slurry or insufflated appears to be more effective than tetracycline derivatives. Experience with talc in slurry for the treatment of spontaneous pneumothorax is still limited. Another treatment modality for spontaneous pneumothorax is thoracoscopy, more recently termed video-assisted thoracic surgery, and it has warranted renewed interest due to the advent of improved endoscopic technology. In the treatment of spontaneous pneumothorax, video-assisted thoracic surgery is nearly as effective as thoracotomy.
在过去的一年里，关于自发性气胸的研究主要集中在病因和治疗方面。慢性阻塞性肺疾病仍然是继发性自发性气胸最常见的病因。然而，在艾滋病患者中，卡氏肺孢子虫感染已成为自发性气胸在高患病率人群中的主要病因。自发性气胸的治疗方法之一是胸腔闭式引流并注入四环素作为硬化剂。四环素已不再可用。幸运的是，其衍生物多西环素和米诺环素同样有效。滑石粉悬液或吹入法似乎比四环素衍生物更有效。滑石粉悬液治疗自发性气胸的经验仍然有限。自发性气胸的另一种治疗方法是胸腔镜检查，最近称为电视辅助胸腔手术，由于改进的内镜技术的出现，它重新引起了人们的兴趣。在治疗自发性气胸方面，电视辅助胸腔手术几乎与开胸手术一样有效。
