Wetzer K, Schilling W, Wenzel D, Scheuler D
Z Erkr Atmungsorgane. 1980;155(1):82-8.
The authors start from the fact that till now was a declining attitude in face of the thoracoscopic lung biopsy. Under local anaesthesia any air embolism were happened with it. Moreover there was no optimal instrument for thoracoscopic lung biopsy. Beginning with pressure measurements of the intrathoracic cavity systems the authors research the conditions which can result in air embolism. They found that air embolism is excluded only by unilateral ventilation of the non-biopsied lung of the patient via a channel of Carlens' double-lumen catheter. The other channel of the cathetaer which is connected with the thoracoscopically biopsied lung must be aggreed with the atmosphere in the same way as the pleural space via the open thoracoscope tube. Further it was developed the suction punch, a special instrument for thoracoscopic lung biopsy. In this instrument the proceedings of catch and detache the tissue from the parenchyma are divided contrarily to the forcepslike devices. With this new instrument 63 patients were examined. The thoracoscopic lung biopsy was performed under general anaesthesia with side-separated ventilation through Carlens' catheter. The histologically verified diagnostic yielded was 89 per cent. There aren't serious complications.
到目前为止，人们对胸腔镜肺活检的态度呈下降趋势。在局部麻醉下进行该操作时会发生空气栓塞。此外，当时没有用于胸腔镜肺活检的理想器械。作者们从测量胸腔内系统压力入手，研究可能导致空气栓塞的情况。他们发现，只有通过卡伦斯双腔导管的一个通道对患者未活检的肺进行单侧通气，才能避免空气栓塞。与胸腔镜活检肺相连的导管的另一个通道必须像通过开放的胸腔镜管与胸膜腔一样与大气相通。此外，还研发了一种用于胸腔镜肺活检的特殊器械——吸引活检钳。在这种器械中，从实质组织抓取和分离组织的操作与钳状器械相反。使用这种新器械对63例患者进行了检查。胸腔镜肺活检在全身麻醉下通过卡伦斯导管进行单侧通气。经组织学验证的诊断准确率为89%。未出现严重并发症。
