Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Mayo Foundation for Medical Education and Research, Rochester, MN.
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Mayo Foundation for Medical Education and Research, Rochester, MN..
Chest. 2015 Jan;147(1):e5-e7. doi: 10.1378/chest.14-0814.
Thoracentesis is considered a relatively safe and well-established procedure commonly done at the bedside with minimal risk of complication. Thoracentesis-related hemothorax is uncommon; however, it may be life-threatening. We describe a case of a 19-year-old woman with persistent fever and pleural effusion, in which thoracentesis resulted in tension hemothorax due to intercostal artery laceration. It is important for proceduralists to understand not only the tortuosity of the intercostal artery covering 25% to 50% of the intercostal space, but also the presence of traversing collateral arteries. Herein, we discuss the potential benefit of vascular ultrasonography with color Doppler during thoracentesis, with the goal of avoiding vessel injury and hemorrhage.
胸腔穿刺术被认为是一种相对安全且成熟的操作，通常在床边进行，并发症风险极小。与胸腔穿刺术相关的血胸并不常见，但可能危及生命。我们描述了一例 19 岁女性，持续发热伴胸腔积液，胸腔穿刺术导致肋间动脉撕裂引起张力性血胸。术者不仅要了解覆盖 25%至 50%肋间空间的肋间动脉的迂曲，还要了解穿行的侧支动脉的存在，这一点非常重要。在此，我们讨论了在胸腔穿刺术期间使用彩色多普勒超声进行血管检查的潜在益处，以避免血管损伤和出血。
