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자연기흉에 대한 임상적 고찰 : A Clinical Study of Spontaneous Pneumothorax

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최수승; 서경필

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서울대학교 의과대학
Seoul J Med, Vol.16 No.4, pp. 277-282
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.
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