Treatment of pneumothorax. Especially treatment using the heimlich valve at the outpatient department.

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  • 自然気胸の治療成績　　特にハイムリッヒ弁使用による外来治療について
  • Especially Treatment Using the Heimlich Valve at the Outpatient Department
  • 特にハイムリッヒ弁使用による外来治療について

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Methods of treatment and corresponding prognoses were examined concerning 126 cases of spontaneous pneumothorax treated at the Department of Surgery, Tokyo Medical College, during the 5 year-period between 1980 and 1984.<br>Thoracic drainage using the Heimlich valve was attempted in the outpatient department for patients with a first episode of pneumothorax. Unsuccessfully treated cases were admitted for low pressure continuous drainage or thoracotomy. In the past 2 years about 50% of all cases were treated successfully in the outpatient department by the Heimlich valve, while in most admitted cases surgery was indicated. This suggests that treatment using the Heimlich valve is as effective as continuous drainage and is socially and economically advantageous for patients.<br>In thoracic drainage, including both low pressure continuous drainage and the Heimlich valve, the recurrence rate was 22.2% and all cases of recurrence occured on the same side.<br>In cases treated by thoracotomy, the recurrence rate on the same side was 4.41%, but contralateral occurence was 13.2%. This was considered to be rather high. The possibility that operation promotes contralateral pneumothorax was considered to be a problem requiring further discussion.

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