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首页> 外文期刊>Osaka City Medical Journal >Surgical Indications for Spontaneous Pneumothorax in Patients over 50 Years of Age
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Surgical Indications for Spontaneous Pneumothorax in Patients over 50 Years of Age

机译：50岁以上患者自发性气胸的手术适应症

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Background Surgery is often required in cases of spontaneous pneumothorax. This situation can pose considerable difficulty with correct preoperative estimate of pulmonary function. Simple indications for surgery are mandatory, especially in aged patients. Methods To examine the indications and safety of surgery in patients over 50 years, 23 operations in 22 patients over a 6-year period from 1998 to 2003 were reviewed retrospectively. All 23 cases had a grade 2 or better performance status. In all cases, operations were performed with bullectomy or pneumonorrhaphy by a limited thoracotomy with videothoracoscopy in 5 cases. Results All patients recovered to the same performance status as before the onset of the pneumothoraces, with the exception of one who died, and changes between pre- and postoperative arterial oxygen or carbon dioxide tension were not significant. Lung-related postoperative complications, including 1 mortality (4%), occurred in three cases who required emergency operation because of massive air leaks with incomplete lung reexpansion, obvious mediastinal emphysema or severe subcutaneous emphysema. Conclusions Surgical interventions may be safely performed when the patient's performance status is grade 2 or better, but care must be taken to avoid postoperative complications in preoperative conditions as massive air leaks with incomplete lung reexpansion, obvious mediastinal emphysema or severe subcutaneous emphysema.
机译：自发性气胸患者通常需要进行背景手术。在正确的术前评估肺功能时，这种情况可能会带来很大的困难。手术的简单适应症是强制性的，尤其是对于老年患者。方法回顾性分析1998年至2003年6年间22例患者的23例手术，以回顾50年来50例患者的手术适应症和安全性。所有23例均具有2级或更好的表现状态。在所有病例中，有5例行有限胸腔镜开胸并电视胸腔镜进行了牛切除术或肺积气手术。结果所有患者恢复到与气胸发作之前相同的表现状态，除了一名死亡者外，术前和术后动脉氧或二氧化碳张力之间的变化不显着。由于大量漏气，肺不完全扩张，明显的纵隔肺气肿或严重的皮下气肿，需要紧急手术的3例患者发生了与肺相关的术后并发症，包括1例死亡（4％）。结论当患者的表现状态为2级或更好时，可以安全地进行手术干预，但是在术前应注意避免术后并发症，如大量漏气，肺不完全扩张，明显的纵隔性肺气肿或严重的皮下气肿。

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