자연기흉에 대한 임상적 고찰

Spontaneous Pneumothorax: Clinical Investigation of 142 Cases

We have experienced 142 cases of spontaneous pneumothorax from January 1987 to June 1990 at the department of Thoracic and Cardiovascular Surgery, Inha General Hospital, Inha University College of Medicine. The age of patients ranged from 16 to 79 years \ulcornerold. The incidence was highest between late 2nd and 3rd decades in non tuberculous group. Males occupied 110 cases [77.6%] and females 32 cases [22. 5%], and its ratio was 3.4: l. The incidence of right side pneumothorax was 76 cases [53.5%] and left side was 65 cases [45.8%]. There was one case of bilateral pneumothorax. The most common chief complaints were chest pain and dyspnea. The associated pulmonary lesions were pulmonary tuberculosis, active or healed in 51 cases [35.9%], Subpleural bleb in 19 cases [13.4%], emphysematous bulla in 12 cases [13.4%], asthma in 3, bronchiectasis in 3, pneumonia in 1, cyst in 1. The unknown origin pneumothorax, so called "idiopathic spontaneous pneumothorax”, which seemed to be caused by the rupture of bleb or bulla most likely, were 52 cases [36. 6%] in our series. Generally, closed [tube] thoracotomy with underwater sealed drainage is the treatment of choice in spontaneous pneumothorax. We experienced 94 cases[66.2%] which were cured by closed thoracotomy. However, open thoracotomy and adequate surgical procedures were undertaken in patient with continuous air leakage or recurrent attacks of spontaneous pneumothorax in 48 cases [33.8%]. The minithoracotomy is a good procedure for the bullectomy of upper lobe.lobe.