Spontan pnömotorakslı olgularımızın klinik özellikleri

Abstract

Bu çalışmada spontan pnömotoraks tanısı konulmuş olgularımızın klinik özelliklerini, yapılan tedavileri ve sonuçlarını değerlendirmeyi amaçladık. Ocak 2004 ile Aralık 2008 arasında spontan pnömotoraks tanısı ile tedavi edilen 288 olgu yaş, cinsiyet, etiyoloji, pnömotoraks tipi, uygulanan tedaviler ve sonuçları, morbidite ve mortalite açısından değerlendirildi. Hastaların 266'sı (%92) erkek, 22'si (%8) kadın olup, yaş ortalaması 41.418.1 yıl idi. Çalışmada 148 (%51) primer spontan pnömotorakslı, 140 (%49) sekonder spontan pnömotorakslı olguların bulguları karşılaştırıldı. Spontan pnömotoraks 147 (%51) olguda sağ tarafta, 137 (%47) olguda sol tarafta, dört olguda her iki hemitoraksta saptandı. Her iki grupta da en sık saptanan belirti nefes darlığı idi. Sekonder spontan pnömotorakslı olgularda kronik obstrüktif akciğer hastalığı en sık saptanan nedendi. Bu seride 49 olguda nüks gelişti. Cerrahi tedavi uygulanan 70 olgudan 67 olguya aksiller torakotomi veya lateral torakotomi ve 3 olguya video yardımlı torakoskopik cerrahi uygulandı. Dokuz (%3) olguda morbidite tespit edildi (8 olguda uzamış hava kaçağı ve 1 olguda kanama). Cerrahi tedavi uygulanan olgularda mortalite izlenmedi. Ortalama hastanede yatış süresi 9.35.3 (1–33) gündü. Spontan pnömotoraksta yaş, klinik durum ve altta yatan akciğer hastalığı önemlidir. Uygun tanı ve tedavi ile sonuçları oldukça iyi, morbiditesi ve mortalitesi düşük bir hastalıktır.

In this study we aimed to evaluate the clinical features, treatment modalities performed and outcomes of the patients with spontaneous pneumothorax. Two hundred and eigthy eight patients who were treated with the diagnosis of spontaneous pneumothorax between January 2004 to December 2008 were evaluated according to age, gender, etiology, type of pneumothorax, treatments performed and their consequences, morbidity and mortality. Of the patients, 266 (92%) were male and 22 (8%) were female, and their mean age was 41.4±18.1 years. In the study, findings of 148 (51%) patients with primary spontaneous pneumothorax and of 140 (49%) patients with secondary spontaneous pneumothorax were compared. A spontaneous pneumothorax was detected in 147 (51%) cases, 137 (47%) cases and 4 (2%) cases in the right side, left side and bilaterally, respectively. The most common symptom in both groups was dyspnea. Chronic obstructive lung disease was the most common cause detected in the cases with secondary spontaneous pneumothorax. Recurrence developed in 49 patients in this series. Of the 70 cases performed surgical treatment, axillary thoracotomy or lateral thoracotomy was performed in 67 patients, and video assisted thoracoscopic surgery was performed in 3 patients. Morbidity was detected in 9 (3%) patients (prolonged air leak in 8 cases and hemorrhage in 1 case). No mortality was observed in cases performed surgical treatment. The mean hospitalization period was 9.3±5.3 (1-33) days. Age, clinical condition and underlying lung disease are important in spontaneous pneumothorax. Morbidity and mortality are low and outcomes are pretty good with appropriate diagnosis and treatment.