Systemic Air Embolism Following Computed Tomography-Guided Transthoracic Needle Biopsy-A Case Report

電腦斷層導引肺部細針切片引起之全身性空氣栓塞症：一病例報告

蕭惠元(Hui-Yuan Hsiao) ； 丁燿明(Yao-Min Ting) ； 翁銘偉(Ming-Wei Weng) ； 吳銘庭(Ming-Ting Wu) ； 賴瑞生(Ruay-Sheng Lai)

《胸腔醫學》 25卷5期 (2010/10) Pp. 268-274

https://doi.org/10.29806/TM.201010.0007

摘要

經皮細針胸腔穿刺切片經常用來診斷肺部及縱膈腔疾病，這項檢查可能造成一些併發症，諸如：單純性氣胸、自限性咳血、致命性肺出血及空氣栓塞症。將空氣導入心血管循環系統是一個危險的醫源性傷害，可造成嚴重病症甚至死亡，在所有經皮細針胸腔穿刺切片檢查中，它的發生率介於0.02%到0.4%間。在此我們報告一位患者接受電腦斷層導引切片後，經電腦斷層證實，併發大量全身性空氣栓塞症，初步給予氧氣並穩定生命徵象後，患者接受立即的高壓氧治療，追蹤後並無發生空氣栓塞症相關的後遺症。對於全身性空氣栓塞這個少見的併發症，胸腔醫師必須熟悉且注意，能夠及時診斷並給予高壓氧治療。

關鍵字

空氣栓塞症 ； 電腦斷層導引切片 ； 高壓氧

並列摘要

Percutaneous transthoracic needle biopsy is a common procedure for diagnosing pulmonary and mediastinal lesions. The procedure has many potential complications, ranging from simple pneumothorax or self-limiting hemoptysis to life-threatening pulmonary hemorrhage and air embolism [1]. Introducing gas into the circulation is a major iatrogenic problem which could result in serious morbidity and even death. Among the complications of percutaneous transthoracic needle biopsy, systemic air embolism is life-threatening but extremely rare, with an incidence rate of 0.02% to 0.4%. We reported a case of massive systemic air embolism following computed tomography-guided needle biopsy of a pulmonary lesion. After initial resuscitation, the patient received on-site hyperbaric oxygen therapy and demonstrated no residual clinical sequelae from this complication. Pulmonologists should be aware of this rare complication of systemic air embolism. Prompt recognition and immediate hyperbaric oxygen therapy after initial supportive measures are essential to improve the odds of clinical recovery.

並列關鍵字

air embolism ； CT-guided biopsy ； hyperbaric oxygen therapy