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目的总结肺结核并发自发性气胸的治疗经验。方法总结我科治疗的116例肺结核并发自发性气胸患者的临床资料。结果本组116例患者中,发生2次以上的复发率达8.5%,单纯胸腔闭式引流术治疗复发率21.6%;手术治疗复发率2.2%。气胸总体治愈率94.7%。结论肺结核并发自发性气胸的治疗应强调个体化;因结核病灶的存在,气胸一般通过保守治疗难以愈合,积极的外科手术疗效更确切、可靠;胸腔镜手术创伤小、术后恢复快,应作为首选;术式应以肺修补和大疱切除为主,应用自体胸膜片修补以及肺切缘加固缝合可有效预防术后肺漏气。
Objective To summarize the experience of treating pulmonary tuberculosis complicated with spontaneous pneumothorax. Methods The clinical data of 116 patients with pulmonary tuberculosis complicated with spontaneous pneumothorax treated by our department were summarized. Results Among the 116 patients, the recurrence rate was more than 2 times 8.5%, simple thoracic drainage was 21.6%, and the recurrence rate was 2.2%. The overall rate of pneumothorax was 94.7%. Conclusions The treatment of pulmonary tuberculosis complicated with spontaneous pneumothorax should be individualized. Because of the existence of tuberculosis, pneumothorax is generally difficult to heal by conservative treatment. The positive surgical treatment is more accurate and reliable. The thoracoscope has the advantages of less trauma and faster postoperative recovery. Preferred; surgery should be the main lung repair and bullous resection, the application of self-pleural patch and lung suture reinforcement suture can effectively prevent postoperative lung leakage.