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一名58岁男性的创伤性气胸:一例罕见的针灸后不良事件病例报告

Traumatic Pneumothorax in a 58-Year-Old Man: A Case Report of a Rare Post-Acupuncture Adverse Event.

作者信息

Smith Brittany, Lew Sungyub, Manes Prabhjot

机构信息

Saint George's University School of Medicine, True Blue, Grenada.

Department of Family Medicine, Brooklyn Hospital Center, Brooklyn, NY, USA.

出版信息

Am J Case Rep. 2021 Jan 24;22:e928094. doi: 10.12659/AJCR.928094.

Abstract

BACKGROUND The prevalence of chronic medical conditions continues to rise, as does the number of patients seeking alternative treatments for them. Chronic pain is a prevalent medical complaint and acupuncture often is used to treat it. The Chinese literature documents several adverse events (AEs) associated with acupuncture, including cardiac tamponade, pneumothorax, infection, and nerve injuries. These complications are rare and may be associated with anatomical characteristics of the patients and deep insertion of the acupuncture needles. Differences in body type, weight, height, sex, and muscle mass contribute to anatomical differences and the depth at which vital organs lie. Having a better understanding of these anatomical differences may alter the occurrence of such AEs. CASE REPORT A slim 58-year-old man who was treated for neck pain with acupuncture presented with 2-day history of moderate-severity pleuritic and sharp pain radiating from the left scapula to the midaxillary and retrosternal area. A left-sided pneumothorax was diagnosed on chest X-ray and the patient was treated with a chest tube. CONCLUSIONS This case underscores that acupuncture can result in complications such as a pneumothorax from puncture of the pleura. These types of AEs from acupuncture can be avoided with a better understanding of anatomical differences, including body mass index and variations in depth associated with body size, musculature, or skeletal structure. When placing the needles, it is crucial for practitioners to know that the depth at which vital organs lie may differ between patients.

摘要

背景 慢性疾病的患病率持续上升,寻求替代治疗的患者数量也在增加。慢性疼痛是一种常见的医学主诉,针灸常被用于治疗。中国文献记载了一些与针灸相关的不良事件(AE),包括心脏压塞、气胸、感染和神经损伤。这些并发症很少见,可能与患者的解剖特征和针灸针的深刺有关。体型、体重、身高、性别和肌肉量的差异导致了解剖学差异以及重要器官所处的深度。更好地了解这些解剖学差异可能会改变此类不良事件的发生情况。病例报告 一名58岁的瘦男子因颈部疼痛接受针灸治疗,出现了为期2天的中度至重度胸膜炎性疼痛和从左肩胛骨放射至腋中线及胸骨后区域的锐痛。胸部X光检查诊断为左侧气胸,患者接受了胸腔闭式引流管治疗。结论 该病例强调针灸可导致如因胸膜穿刺引起的气胸等并发症。通过更好地了解解剖学差异,包括体重指数以及与体型、肌肉组织或骨骼结构相关的深度变化,可避免此类针灸引起的不良事件。在进针时,从业者必须清楚重要器官所处的深度在不同患者之间可能存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b5f/7841691/6d3dfa39789c/amjcaserep-22-e928094-g001.jpg

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