자연기흉에 대한 임상적 고찰

Abstract

One hundred and fifty nine patients with spontaneous pneumothorax, 58 patients of whom were seen in the Department of Thoracic Surgery at the National Medical Center between January 1967and May 1975, and the remaining 101 patients in the Department of Thoracic Surgery, Seoul National University Hospital between January 1960 and December 1972, were analyzed. Of the 159 patients, 128 were male and 31 were female. showing a male to female preponderance of 4. 1: 1. 57% of the patients were in the third and fourth decades. 79 patients had a right-sided pneumothorax and 72 patients a left-sided pneumothorax. 8 patients had bilateral spontaneous pneumothorax. Tuberculosis was the etiologic factor in 57.9% , rupture of bullae or blebs in 13.8% , acute pulmonary infection in 5.7%, pulmonary paragonimiasis in 2.5%, and unknown causes in 20.1%. Sudden attack of shortness of breath (91%) , chest pain (57%) , and cough (25%) were the most common chief complaints. In the majority of the patients(60%) , the degree of collapse of the involved lung was more than 50% on chest roentgenograms. The most frequently employed method of treatment was closed tube drainage. In this series, successful pulmonary expansion was obtained with bed rest alone in 6 patients. Needle aspiration was done in 36 patients, of whom 13 showed complete expansion. In the remaining 23 patients additional closed thoracotomy drainage was necessary. Closed thoracotomy drainage was performed in 140 patients, showing successful expansion in 109 of the cases. In the remaining 31 cases open thoracotomy was inevitable.