Objective: To investigate the short-term and long-term effects of pulmonary bulla resection combined with pleurodesis versus pulmonary bulla resection in the treatment of elder chronic obstructive pulmonary disease (COPD) with intractable pneumothorax. Methods: A total of 98 patients diagnosed as COPD with intractable pneumothorax were enrolled. They were divided into the pulmonary bulla resection combined with pleurodesis group (group A, n=50) and the pulmonary bulla resection group (group B, n=48). The general data, perioperative related indicators, postoperative adverse reactions and complications, postoperative recurrence, serological and respiratory function evaluation indexes before and 2 weeks after surgery were compared. The survival analysis was performed by K-M method. Results: In group A, the intraoperative blood loss, operation time were more than group B,postoperative drainage tube indwelling time and postoperative hospital stay were shorter than those in group B. The incidence of continuous air leak, intrathoracic hemorrhage and subcutaneous emphysema in group A was lower than those in group B. Two weeks after operation, the values of partial pressure of oxygen (PaO2), forced vital capacity (FVC), forced expiratory volume in the first second as a percentage of the expected value(FEV1%) in group A were lower than those in group B, and the values of partial pressure of carbon dioxide in artery (PaCO2) and COPD assessment test (CAT) were higher than those in group B. The above differences were statistically significant (P<0.05). The short-term recurrence rate in group A (2.00%) was lower than that in group B (14.58%), the difference was statistically significant (P<0.05). The long-term recurrence rate in group A (22.92%) was similar to that in group B (21.74%), there was no statistical significance (P>0.05). The survival rate of group A (89.58%) was lower than that of group B (95.65%), but the difference was not statistically significant (P>0.05). Conclusion: In the treatment of COPD intractable pneumothorax, pulmonary bulla resection combined with pleurodesis can achieve satisfactory short-term results, but long-term results are not ideal compared with pulmonary bulla resection.
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