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张力性气胸作为经支气管超声引导下纵隔淋巴结经支气管细针穿刺活检的严重并发症。

Tension pneumothorax as a severe complication of endobronchial ultrasound-guided transbronchial fine needle aspiration of mediastinal lymph nodes.

作者信息

Gnass Maciej, Szlubowski Artur, Gil Tomasz, Kocoń Piotr, Ziętkiewicz Mirosław, Twardowska Magdalena, Kużdżał Jarosław

机构信息

Independent Endoscopy Unit, John Paul II Specialist Hospital in Krakow, Poland.

Clinical Department of the Clinic of Thoracic Surgery, Collegium Medicum of the Jagiellonian University, John Paul II Specialist Hospital in Krakow, Poland.

出版信息

Kardiochir Torakochirurgia Pol. 2015 Dec;12(4):359-62. doi: 10.5114/kitp.2015.56790. Epub 2015 Dec 30.

Abstract

This article presents a case report of a patient suffering from bullous emphysema and chronic obstructive pulmonary disease, who was diagnosed with tension pneumothorax after undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Tension pneumothorax is a severe but rare complication of EBUS-TBNA. It can result from lung injury caused by the biopsy needle or, in patients suffering from bullous emphysema, from spontaneous rupture of an emphysematous bulla resulting from increased pressure in the chest cavity during cough caused by bronchofiberoscope insertion. The authors emphasize that patients should be carefully monitored after the biopsy, and, in the case of complications, provided with treatment immediately in proper hospital conditions. Patients burdened with a high risk of complications should be identified before the procedure and monitored with extreme care after its completion.

摘要

本文介绍了一例患有大疱性肺气肿和慢性阻塞性肺疾病的患者病例报告,该患者在接受支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)后被诊断为张力性气胸。张力性气胸是EBUS-TBNA的一种严重但罕见的并发症。它可能由活检针导致的肺损伤引起,或者在患有大疱性肺气肿的患者中,由支气管纤维镜插入引起咳嗽时胸腔压力增加导致肺气肿大疱自发破裂所致。作者强调,活检后应对患者进行仔细监测,如出现并发症,应在适当的医院条件下立即进行治疗。在手术前应识别出具有高并发症风险的患者,并在手术完成后进行极其仔细的监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/4735541/879043fb150c/KITP-12-26547-g001.jpg

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