天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (4): 381-384.doi: 10.11958/20170010

• 临床研究 • 上一篇    下一篇

单中心 1 128 例原发自发性气胸术后复发危险因素分析

石珍亮 1， 张逊 1， 李月川 2△   

  1. 1 天津市胸科医院胸外科 （邮编 300051）， 2 呼吸与危重症医学科
  • 收稿日期:2017-01-05 修回日期:2017-03-03 出版日期:2017-04-15 发布日期:2017-04-15
  • 通讯作者: △通讯作者 E-mail：liyuechuandoctor@126.com E-mail:liyuechuandoctor@126.com
  • 作者简介:石珍亮 （1980）， 男， 主治医师， 硕士， 主要从事胸外科微创诊疗研究

Retrospective study on rick factors of postoperative recurrence of primary spontaneous pneumothorax in 1 128 patients at a single center

SHI Zhen-liang1, ZHANG Xun1, LI Yue-chuan2△   

  1. 1 Department of Thoracic Surgery, 2 Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital,Tianjin 300051, China
  • Received:2017-01-05 Revised:2017-03-03 Published:2017-04-15 Online:2017-04-15
  • Contact: △Corresponding Author E-mail：liyuechuandoctor@126.com E-mail:liyuechuandoctor@126.com

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摘要： 目的 分析原发自发性气胸术后复发的危险因素。方法 整理 2009 年 1 月—2015 年 3 月天津市胸科医 院胸外科单中心 1 128 例自发性气胸手术治疗患者临床特征、 围手术期相关因素及术后复发情况， 分析以上因素与 术中是否发现肺大泡之间的关系， Logistic 回归分析评估自发性气胸术后复发的影响因素。结果 在所有 1 128 例 自发性气胸手术患者中肺大泡患者 877 例， 肺大泡的发生率在年龄较小组（＜25 岁）高于年龄较大组（≥25 岁， P ＜ 0.05）； 肺大泡组手术时间较无肺大泡组延长 （P＜0.05）。手术后复发 21 例， 复发率为 1.86%。Logistic 回归分析提示 有肺大泡、 术中胸膜固定时未行胸膜摩擦及术后引流时间延长（＞ 3 d）是自发性气胸术后复发的危险因素（P＜ 0.05）。结论 临床中对自发性气胸患者同时合并肺大泡、 术中胸膜固定时未行胸膜摩擦及术后引流时间延长者要 注意自发性气胸术后复发的风险。

关键词: 气胸, 复发, 胸膜固定术, 引流术, Logistic 模型, 危险因素, 肺大泡

Abstract: Objective To analyze rick factors for postoperative recurrence of spontaneous pneumothorax surgery. Methods The clinic characteristics of 1 128 patients who received spontaneous pneumothorax surgery in Tianjin Chest Hospital were collected from January 2009 to March 2015. The relationship between clinic characteristics and the pulmonary bullae was analyzed. Logistic regression analysis was used to assess factors affecting the postoperative relapse of spontaneous pneumothorax. Results The pulmonary bullae were found in 877 patients of 1 128 during the operation. The incidence of pulmonary bullae was significantly high in patients with age below 25 years compared with patients over 25 years (P＜0.05). The duration of surgery was significantly longer in patients with pulmonary bullae compared with that of patients without pulmonary bullae (P＜0.05). Postoperative recurrence occurred in 21 cases, with a recurrence rate of 1.86% . Logistic regression analysis showed that pulmonary bullae, pleurodesis without pleura friction, delayed drainage duration (＞ 3 d) were independent risk factors of postoperative recurrence for spontaneous pneumothorax (P＜0.05). Conclusion Pulmonary bullae, pleurodesis without pleura friction and delayed drainage duration are risk factors of postoperative recurrence for spontaneous pneumothorax, which should be paid more attention in clinic.

Key words: pneumothorax, recurrence, pleurodesis, drainage, Logistic models, risk factors, lung bullae