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外科的 自然氣胸의 臨床的 考察

Clinical Investigation of Surgical Spontaneous Pneumothorax

대한흉부외과학회지 1968년 1권 1호 p.19 ~ 23
윤윤호,
소속 상세정보
윤윤호 (  ) - 연세대학교 의과대학 흉부외과학교실

Abstract


A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical management.
Males outnumbered females 15:2 Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abcess, cyst and blebs.
It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abcess, cyst, blebs were above 4th decade. Pulmonary tuberculosis was far advanced bilateral and active.
The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed.
The complications were pleural effusion and bronchopleural fistula. The former was 13 cases (76.4%) in which 3 cases combined with mixed infection, and latter was 5 cases.
As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suction. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage.
This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho pleural fistula.
The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases.
Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis.
Decortication & lung resection was carried out in 2 patients among which ruptured lung abeess 1 case and ruptured multiple blebs 1 case.
There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.

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