Iberti T J, Katz L B, Reiner M A, Brownie T, Kwun K B
Surgery. 1983 Nov;94(5):842-6.
Two cases of delayed onset hydrothorax following central venous catheterization are reported. Both involved left internal jugular vein percutaneous insertion sites, and chest roentgenograms of both demonstrated that the catheter tips were juxtaposed against the superior vena cava wall. Although both catheters functioned well for several days, we believe that this left neck site allowed for catheter tip motion, resulting in delayed perforation of the vessel. To avoid this complication we recommend that central venous catheters be checked routinely for position, with the catheter tip being parallel to the vessel wall. The left neck approach should be avoided if possible because of anatomic and mobility problems. These cases emphasize the fact that hydrothorax can occur long after successful catheter insertion, and they demonstrate the need to have continued suspicion of the possibility of this occurrence.
本文报告了两例中心静脉置管后迟发性胸腔积液的病例。两例均涉及经皮穿刺左颈内静脉置管，胸部X线片均显示导管尖端紧贴在上腔静脉壁上。尽管两根导管在数天内功能良好，但我们认为左颈部置管部位允许导管尖端移动，导致血管延迟穿孔。为避免这种并发症，我们建议常规检查中心静脉导管的位置，使导管尖端与血管壁平行。由于解剖结构和活动问题，应尽可能避免采用左颈部置管方法。这些病例强调了胸腔积液可在置管成功后很长时间才出现这一事实，并且表明需要持续怀疑有发生这种情况的可能性。
