Comparison Among Different Medical Treatments For Spontaneous Pneumothorax

Objective We investigated the clinical characteristics of spontaneous pneumothorax,and also the selection and curative effect of medical treatment about it.Methods We made three different comparisons, according to different medical treatment.1. conservative treatment versus needle aspiration. We divided stable patients with amoderate PSP into these two groups, to compare the absorption rate and theeffectiveness.2. needle aspiration versus small-bore chest tube with manual aspiration. We dividedstable patients with a moderate or large PSP into these two groups, to compare theabsorption time and the effectiveness.3. small-bore chest tube drainage in negative pressure versus traditional large-borechest tube drainage. We divided stable patients with a large PSP into these twogroups, to compare the effectiveness, complication rate, remission time, drainageduration, and the length of stay.Results1. In conservative treatment group, the success rate was84%(21/25), similar to80%(20/25) in NA group(P＞0.05), and absorption rate was6.63±0.42%per day,longer than6.20±0.60%per day in NA group(P=0.01).2. In small-bore chest tube group, the success rate was91.7%(33/36),little higher than70.0%(21/30) in NA group(P*=0.029), and absorption time was4.56±0.70day, similarto4.89±0.90day in NA group(P＞0.05).3. There was no significant difference between small-bore chest tube(SCT) group andlarge-bore chest tube group(LCT) in success rate(SCT84%versus LCT91.3%, P＞0.05) and drainage duration(SCT4.88±0.55day versus LCT5.21±0.77day, P＞0.05).However, SCT has shorter length of stay(5.64±0.62day versus7.2±0.78day, P＜0.01)and lower complication rate(8%versus34.7%, P=0.022),but longer remission time(40.48±14.31min versus20.48±7.4min, P＜0.01).Conclusion It’s safe and effective to use conservative treatment for a small PSP patientand also a moderate PSP patient. Small-bore chest tube can be used to treat all SP abovesmall-size, then considered to be with delayed aspiration, needle aspiration or drainage innegative pressure, according to onset time and breach condition. Large-bore chest tube canbe used on such conditions:①small-bore chest tube drainage failure;②critical patients ifbreathless or hemodynamically unstable already.