Abstract：
This study investigated recurrence rates and treatment efficacy based on tomographic findings during a long-term follow-up after primary spontaneous pneumothorax (PSP) treatment. We retrospectively analyzed patients with PSP treated at our hospital between 2003 and 2020. Patients were categorized into 2 groups based on computed tomography (CT) findings: group 1 (no bulla/bleb) and group 2 (bullae-bleb <3 cm). Data on demographics, recurrence, treatment methods, and outcomes were also collected and compared. A total of 251 PSP cases were evaluated, predominantly male (93.6%) with a mean age of 29.23 ± 1.14 years. Most cases (57%) occurred on the right side. Recurrence rates were highest within the first year (77.8%), with the first and second recurrences occurring at rates of 26% and 27.3%, respectively. In group 1 (n = 117), conservative treatment was applied in 15 cases, tube thoracostomy in 81, autologous blood pleurodesis (ABP) in 19, and surgery in 12. Recurrence rates were 46.6%, 21%, 5.3%, and 8.3%, respectively. In group 2 (n = 134), the recurrence rates were 50%, 32.7%, 20%, and 3.1%, respectively (P < .001). No mortality was observed for any patient. The treatment groups included conservative (n = 19), thoracostomy (n = 179), ABP (n = 34), and surgical (n = 44) groups. Recurrence rates were 47.3%, 27.4%, 11.8% (group 1: 5.3%, group 2: 20%, P = .035), and 4.5% (0% vs 6.3%), respectively. ABP effectively reduced recurrence in group 1 PSP patients without bullae or blebs on CT, potentially avoiding surgery. Video-assisted thoracoscopic surgery should be preferred in group 2 cases with bullae or blebs to minimize recurrence. These results underscore the importance of tailoring treatment strategies based on CT findings to optimize PSP management outcomes.
摘要：
这项研究调查了原发性自发性气胸（PSP）治疗后长期随访中基于断层扫描结果的复发率和治疗效果。我们回顾性分析了2003年至2020年在我院接受治疗的PSP患者。根据计算机断层扫描（CT）发现将患者分为2组：第1组（无大泡/大泡）和第2组（大泡<3cm）。人口统计数据，复发,治疗方法,并收集和比较结果.总共评估了251例PSP病例，主要为男性（93.6％），平均年龄为29.23±1.14岁。大多数病例（57％）发生在右侧。第一年的复发率最高（77.8%），第一次和第二次复发的发生率分别为26%和27.3%，分别。在第1组（n=117）中，保守治疗15例，81例管状胸腔镜造口术，19例自体血胸膜固定术（ABP），12例手术。复发率为46.6%,21%,5.3%,和8.3%，分别。在第2组（n=134）中，复发率为50%,32.7%,20%,和3.1%，分别(P<.001)。没有观察到任何患者的死亡。治疗组包括保守组(n=19)，胸腔造口术（n=179），ABP（n=34），和手术组（n=44）。复发率为47.3%,27.4%,11.8%(第1组:5.3%,第2组：20%，P=.035)，和4.5%(0%对6.3%)，分别。ABP有效地减少了第1组PSP患者的复发，在CT上没有大疱或气泡，可能避免手术。第2组有大疱或大泡的患者应首选电视胸腔镜手术，以最大程度地减少复发。这些结果强调了根据CT发现调整治疗策略以优化PSP管理结果的重要性。
