Guiding Values Of Spontaneous Pneumothorax With Lung Compressed Form For The Choice Of The Treatment

Objective: To evaluate the guiding values of spontaneous pneumothorax with lung compressed form guiding values for the choice of the treatment.Methods: A retrospective study reviewed spontaneous pneumothorax patients treat and cure in Tianjin Chest Hospital in June 2012 to July 2014. According to the posteroanterior thorax X-ray shows lung compressed form divided spontaneous pneumothorax into 2 groups the periphery shape and irregular shape.We observe the ralationship among the lung compressed form with the previous numbers of closed thoracic drainage,the rate of cure closed thoracic drainage in 7 days,the cure time of closed thoracic drainage and the incidents rate of the surgical patients pleual adhesions.Results: 1、A total of 219 patients in accordance with the inclusive criteria,included 127 cases of peripheral shape and 92 irregular shape.There are no significant differences in gender,age,location of the pneumothorax and the compression range between the two groups(P>0.05). 2、13 cases of Irregular shape patients previous had not received the closed thoracic drainge treatment, previous receive once closed thoracic drainage treated 33 cases of patients,previous receive twice and more closed drainage treated 46 cases of patients, the incidences of irregular shape are 11.71%(13/111), 57.89%(33/57)and 90.10%(46/51),with the closed thoracic drainge treatment number incresed,the three pairwise comparisons were statistically different(χ2=96.339,P<0.01). 3、Patients with peripheral shape cured 94 cases of closed thoracic drainage,7days to cure 85 cases,cure rate 90.4%(85/94),the average time of cure 4.00±2.07d; Patients with irregular shape cured 30 cases of closed thoracic drainage,7days to cure 11 cases,cure rate 36.7%(11/30),cure the average time of 10.10±4.87 d. Irregular shape patients with closed thoracic drainage 7days cure rate lower than the peripheral shape(χ2=37.596,P<0.01), the cure time higher than a peripheral shpae(t=9.806,P<0.01). 4、95 patients with surgical treatment,peripheral shape 33 cases,intraoperative pleural adhesions are 6 cases,irregular shape 62 cases,intraoperative pleural adhesions are 57 cases,pleural adhesion rates were 18.2%(6/33),91.8%(57/62). The incidence of pleural adhesions is higher in irregular shape patients.The difference is statistically significant(χ2=52.445,P<0.01).Conclusion Using the posteroanterior thorax X-ray shows lung compressed form different,for the Spontaneous pneumothorax patient treatment of choice is guiding values.When the patients thorax X-ray shows lung compressed form are peripheral shape prove the first time in patients with the disease,the treatment of closed thoracic drainage,7d cure rate high,cure time is short,introperative visible the incidence of pleural adhesions is low;When the patients thorax X-ray shows lung compressed form are irregular shape prove the patients recurrent pneumothorax,and previously has been closed thoracic drainage and other invasive treatment,the closed thoracic drainage again,7d cure rate low,cure time is long,introperative visible the presence of pleural adhesions.So for the spontaneous pneumothorax in patients lung compressed form is irregular type should be treated surgically.