Spontaneous Pneumothorax in Children

兒童自發性氣胸

黃健燊(Kin-Sun Wong) ； 劉會平(Hui-Ping Liu) ； 饒啓明(Kee-Ming Yeow)

《Acta Paediatrica Taiwanica》 41卷5期 (2000/10) Pp. 263-265

https://doi.org/10.7097/APT.200010.0263

摘要

自1994年七月至1999年六月，於本院共有16位病童因自發性氣胸住院治療。本報告回溯病童之臨床主訴，胸部攝影，開刀手術治療之適應症及預後。好發年齡爲12-17歲之青春期兒童。其中六人祇接受胸管插入治療，九人以胸腔鏡作肺肋膜下及肺內皰囊之摘除。其中一人有肺內肺氣腫需接受肺支葉切除，又一例併發血胸及出血性休克。高解析胸部電腦斷層攝影對肺尖之皰囊性病變診斷率高。因使用胸腔鏡摘除肋膜下及肺內皰囊併發症及復發率低，兒童期自然性氣胸，可攷慮以胸腔鏡摘除之手術治療。

關鍵字

自發性氣胸 ； 胸腔鏡手術

並列摘要

Sixteen consecutive children diagnosed with spontaneous pneumothorax (SP) and admitted to Chang Gung Children's Hospital between July 1994 and June 1999 were retrospectively studied. The presenting features, radiographic abnormalities, and indications of surgery were reviewed. All patients were exclusively adolescents and were aged between 12 and 17 years. Six patients received chest tube drainage only. Nine patients underwent ablation of blebs or bullae using video-assisted thoracoscopic surgery (VATS) with good results. One patient had a bullous emphysema removed by wedge resection. One patient with spontaneous hemopneumothorax required a blood transfusion and emergent thoracotomy for stabilization. Computed tomographic (CT) scans of the chest detected all seven (100%) cases with apical bulla formations. First episodes of spontaneous pneumothorax were treated conservatively using closed tube thoracostomy if the plain chest radio graphs and CT scans were negative for apical bleb or bulla formations. In summary, SP occurred exclusively in adolescents in this study, commonly they had no underlying pulmonary abnormalities except for bulla or bleb formations. SP can be safely and effectively managed using VATS and abrasive pleurodesis in children without recurrence at follow-up. SP may be treated surgically even in the first event of pneumothorax when subpleural blebs are demonstrated by high-resolution computed tomographic scans.

並列關鍵字

spontaneous pneumothorax ； video-assisted thoracoscopic surgery