本文選題：慢性阻塞性肺疾病 + 自發(fā)性繼發(fā)性氣胸�。� 參考：《天津醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討影響COPD并發(fā)氣胸患肺復(fù)張的因素。 方法：通過參考胸腔氣體壓力分析標(biāo)準(zhǔn)、氣胸壓縮范圍計(jì)算方法及CAT評(píng)分標(biāo)準(zhǔn),觀察不同氣胸類型、患肺壓縮范圍、發(fā)病至臨床干預(yù)時(shí)間及CAT評(píng)分對(duì)患肺復(fù)張的影響。 結(jié)果：1、納入111例COPD繼發(fā)性氣胸患者中,94例患者到達(dá)觀察終點(diǎn),其中張力性氣胸(47例)、閉合性氣胸(27例)、交通性氣胸(20例)的患肺復(fù)張時(shí)間分別為91.91±45.68h、56.89±27.56h、120.00±46.07h,三者比較有差異(G=13.800,P0.01)。2、47例張力性氣胸患者行胸腔閉式引流術(shù)后24h內(nèi)完全復(fù)張2例(4.26%),72h內(nèi)完全復(fù)張21例(44.68%),7d內(nèi)復(fù)張22例(46.810,6),10d內(nèi)復(fù)張2例(4.26%)：27例閉合性氣胸患者行胸腔閉式引流術(shù)后24h完全復(fù)張7例(25.93%),72h內(nèi)完全復(fù)張17例(62.96%),7d內(nèi)完全復(fù)張3例(11.11%)；20例交通性氣胸患者行胸腔閉式引流術(shù)后24h內(nèi)完全復(fù)張0例,72h內(nèi)完全復(fù)張5例(25.000%),7d內(nèi)完全復(fù)張13例(65.00%),1Od內(nèi)完全復(fù)張2例(10.00%)。到達(dá)觀察終點(diǎn)的94例患者中,24h內(nèi)完全復(fù)張9例(9.57%),3d內(nèi)完全復(fù)張52例(55.32%),7d內(nèi)完全復(fù)張90例(95.74%),10d內(nèi)復(fù)張4例(4.26%)。3、根據(jù)患肺壓縮范圍分為≤30%亞組、30%亞組,張力性氣胸兩亞組的患肺復(fù)張時(shí)間分別為：84.80±54.16h、98.52±41.08h (t=-0.988, P0.05);閉合性氣胸兩亞組患肺復(fù)張時(shí)間分別為：64.00±27.71h、51.43±28.02h (t=1.146, P0.05);交通性氣胸兩亞組患肺復(fù)張時(shí)間分別為：111.00±36.14h、126.00±52.31h (t=-0.704, P0.05)。4、根據(jù)發(fā)病至臨床干預(yù)時(shí)間分為≤72小時(shí)亞組、72小時(shí)亞組,張力性氣胸兩亞組患肺復(fù)張時(shí)間分別為：102.18±50.27h、70.29±28.96h (t=2.214, P0.05);閉合性氣胸兩亞組患肺復(fù)張時(shí)間分別為：72.00±28.95h.44.80±20.01h (t=2.884, P0.05)交通性氣胸兩亞組患肺復(fù)張時(shí)間分別為：135.43±46.70h、84.00±13.15h (t=2.616, P0.05)。5、根據(jù)患者CAT評(píng)分分為≤20分亞組、20分亞組,張力性氣胸兩亞組患肺復(fù)張時(shí)間分別為：73.09±33.52t、109.92±50.95h (t=-2.884, P0.05)閉合性氣胸兩亞組患肺復(fù)張時(shí)間分別為：46.50±23.95h、72.00±26.29h (t=-2.613, P0.05):交通性氣胸兩亞組患肺復(fù)張時(shí)間分別為：85.33±27.13h、148.36±38.43h(t=-4.140, P0.05)。 結(jié)論：慢性阻塞性肺疾病繼發(fā)氣胸患者中,閉合性氣胸患肺完全復(fù)張時(shí)間短于張力性氣胸及交通性氣胸,張力性氣胸患肺完全復(fù)張時(shí)間短于交通性氣胸；發(fā)病至就診行胸腔閉式引流時(shí)間越長(zhǎng)患肺復(fù)張時(shí)間越短,反之患肺復(fù)張時(shí)間越長(zhǎng)；CAT評(píng)分越低患肺復(fù)張時(shí)間越短,反之患肺復(fù)張時(shí)間越長(zhǎng)；患肺復(fù)張時(shí)間與氣胸壓縮范圍無關(guān)。
[Abstract]:Objective: to investigate the factors influencing pulmonary retensions in COPD complicated with pneumothorax. Methods: the effects of different types of pneumothorax, the range of lung compression, the time of clinical intervention and the CAT score on the reexpansion of lung were observed by referring to the standard of chest gas pressure analysis, the calculation method of pneumothorax compression range and the CAT score. Results of the 111 COPD secondary pneumothorax patients, 94 reached the observation end point. Among them, 47 cases of tension pneumothorax, 27 cases of closed pneumothorax, 20 cases of traffic pneumothorax, respectively.) the time of reexpansion of lung was 91.91 鹵45.68 h, 56.89 鹵27.56 h, 120.00 鹵46.07 h, respectively. There was a difference among the three groups. There were differences among the three groups. There were two cases with tension pneumothorax within 24 hours after closed drainage. Within 7 days, 22 cases (46.81010) and 2 cases (4.26: 27) with closed pneumothorax were treated with thoracic closed pneumothorax within 24 hours, 7 cases (7 cases) with complete retraction within 25.932h, 17 cases with complete retraction within 7 days (62.96%), 3 cases (11.1111) with traffic pneumothorax within 7 days. Within 24 hours after closed drainage of thoracic cavity, 0 cases were completely restored within 72 hours, 5 cases were completely restored within 25.000 days, 13 cases were completely restored within 7 days, 65.00% and 2 cases were completely restored within 1 Od. Among the 94 patients who reached the end of observation, 9 cases (9. 57%) were completely restored within 24 h and 52 cases (52 cases) were completely restored within 3 d within 55.32% / 7 d, 90 cases (95. 74%) within 10 days, 4 cases (4. 26%) were divided into 30% subgroup (鈮，

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