人工抽吸治療電腦斷層導引切片術引發之氣胸

一般肺臟腫瘤可藉由支氣管內視鏡檢查取得檢體。如果肺腫瘤長的位置遠離較大的支氣管，無法使用支氣管鏡時，就須要用電腦斷層來取得組織切片檢體，進行病理化驗。但其檢查過程卻易發生氣胸及血胸的併發症，尤以氣胸發生的特別急劇。此時如沒有緊急治療病患的氣胸，將危害到病人的生命安危。此研究方法就是當病患在做電腦斷層切片檢查中，發生中度或嚴重的氣胸時，由放射科醫師立即在檢查台上，利用靜脈留置軟針及50㏄空針管的人工抽吸方式，將胸腔內多餘的空氣外抽。反覆抽吸約5–10分鐘後，再利用電腦斷層掃描氣胸的位置。待確定氣胸情形已經減緩時，就可將軟針外把，完成這個簡易人工抽吸治療。本研究連續收集154位做切片檢查的病例，共有34位(22.1%)發生氣胸，其中有9位發生中度或嚴重氣胸，且都立即使用簡易人工抽吸治療。最後在這34位氣胸患者中，有32位只需照胸部X光追蹤即可，只有2位(1.3%)因延遲性氣胸而配置胸腔引流管。這個結果發現，當病患於檢查中發生中度或嚴重氣胸時，立即使用簡易人工抽吸治療，確實可以避免病人配置胸腔引流管的機率。有了此法將降低病患做電腦斷層切片檢查的風險，維護到病患安危，同時也能做為臨床相關專科的參考依據。

關鍵字

氣胸；靜脈留置軟針；人工抽吸治療

並列摘要

Generally, specimens of lung tumors can be obtained by with bronchoscopy. However, the specimens cannot be acquired by bronchoscopy when they arise from more distally and smaller bronchi and CT-guided biopsy is needed. When lung is traversed, pneumothorax and hemothorax can happen and they are the most common complications. Pneumothorax can be a dangerous condition, because it may progress quickly causing tension pneumothorax and the condition is life-threatening. When moderate or severe pneumothoraces occur during or after CT-guided needle biopsy, we immediately insert an intravenous catheter (IC) into the pleural cavity and perform air aspiration using a 50m1 syringe, until patient's symptom/sign caused by pneumothorax is relieved. We then remove the IC. In this study there were 34 (22.1%) pneumothoraces occurred after 154 biopsy procedures, 9 were moderate or severe, and treated by immediate manual aspiration. In 32 of the 34 pneumothoraces, the pneumothorax had resolved completely on follow-up chest radiographs. Only 2 patient (1.3%. 2 of 154) required chest tube placement. The method of treating pneumothorax may lower the chest tube insertion rate and patient morbidity.

並列關鍵字

pneumothorax ； intravenous catheter ； air aspiration

國際替代計量

人工抽吸治療電腦斷層導引切片術引發之氣胸

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