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早期排气与延迟排气对原发性自发性稳定型气胸治疗效果分析

  

  1. 福建医科大学附属泉州市第一医院 呼吸科, 福建 泉州 362000
  • 出版日期:2018-04-05 发布日期:2018-04-24
  • 通讯作者: 通信作者:蔡志明,Email:cai709924110@163.com

Analysis of the different outcomes between immediate therapy and delayed therapy in patients with stable primary spontaneous pneumothorax

  1. Department of Respiratory Medicine, Quanzhou First Hospital  affiliated to Fujian Medical University,Quanzhou 362000, China
  • Online:2018-04-05 Published:2018-04-24
  • Contact: Corresponding author: Cai Zhiming,Email: cai709924110@163.com

摘要: 目的 分析早期排气与延迟排气对原发性自发性稳定型气胸(PSP)治疗效果的影响。方法 对本院收治83例PSP患者随机分为早期排气组(n=41)与延迟排气组(n=42),比较2组住院时间及初始治疗成功率,并分析出院时间延长的影响因素。结果 早期排气组住院时间短于延迟排气组(P<0.01)。单因素分析结果显示采用延迟排气方法、大量气胸(气胸压缩面积≥50%)、右侧气胸与住院时间延长有关(P<0.05)。多因素COX比例风险回归分析显示延迟排气、大量气胸为住院时间延长的危险因素(P<0.05)。大量气胸者,延迟排气较早期排气初始治疗成功率高(P<0.01)。少量气胸者,早期排气组住院时间短于延迟排气组(P<0.01);并且7天出院率较延迟排气组高(P<0.01)。结论 气胸压缩面积≥50%的稳定型PSP,延迟排气可提高初始治疗成功率,并且不延长住院时间及影响7天出院率。若20%<气胸压缩面积<50%,部分患者可门诊治疗。

关键词: 气胸, 延迟排气, 住院时间, 初始治疗成功率

Abstract: Objective  To explore the different clinical outcomes in patients with stable primary spontaneous pneumothorax(PSP) treated with immediate therapy or delayed therapy. Methods  Eightythree patients admitted in the hospital  were randomly allocated to  immediate group(n=41) and delayed group(n=42). The durations of hospital stays of the two groups and the success rate of their primary treatment were compared.  The KaplanMeier method and the COX regression were used to analyze factors associated with hospital stay.  Results  The duration of hospital stay in immediate group was significantly longer than that of delayed group(P<0.01).  Univariate analysis showed that delayed treatment and large pneumothorax (pneumothorax size ≥50%), as well as right side pneumothoraxes were associated with prolonged hospital stay. However, only delayed treatment and large pneumothorax were risk factors for prolonged hospital stay by  multivariate COX proportional risk regression analysis(P<0.05). The immediate group was better on both  hospital stay and  discharge rate on day 7 compared to the delayed group for patients with small PSP(P<0.05). The immediate success rate for large PSP could be significantly improved by means of delayed treatment compared to the immediate treatment(P<0.01).  Conclusion  Without prolonging the duration of hospital stay, the delayed treatment shows higher immediate success rate for large stable PSP compared with that of the immediate treatment. Conservation may be choice of the outpatient management for some patients with stable small PSP.

Key words: pneumothorax, delayed treatment, hospital stay, the immediate success rate