Cormier Y, Laviolette M, Tardif A
Thorax. 1980 Jan;35(1):37-41. doi: 10.1136/thx.35.1.37.
In an attempt to decrease pneumothorax after transthoracic needle lung biopsy we evaluated the effect of breathing 100% oxygen during the procedure. Fifty consecutive biopsies on 46 hospital patients were performed on subjects breathing either oxygen or compressed air. The selected gas, chosen randomly, was given for five minutes before the biopsy and continued for 30 minutes after. Twenty-six procedures were on air (group 1) and 24 on pure oxygen (group 2). Four subjects in group 2 were eliminated from analysis because they were unable to sustain the required oxygen breathing. Results showed fewer pneumothoraces with subjects breathing oxygen (four out of 20) than with those breathing air (11 out of 26). Three patients in group 1 required chest tube drainage for symptoms of dyspnoea, but none were required in group 2. The peak area of gas accumulation for each pneumothorax was smaller in group 2, with a mean surface area of 27·1 cm (range 9·6-63·8), than in group 1 mean of 68·1 cm (range 6·4-172·4). The rather surprising finding of fewer pneumothoraces in the oxygen group may be explained by rapid absorption of small leaks immediately after lung puncture. These results were statistically significant (p<0·05). We conclude that 100% oxygen breathing during transthoracic needle biopsy decreases the number and size of pneumothoraces and propose this simple technique to decrease the morbidity of transthoracic needle lung biopsy.
为了减少经胸针吸肺活检术后气胸的发生，我们评估了在操作过程中呼吸100%氧气的效果。对46例住院患者连续进行了50次活检，受试者分别呼吸氧气或压缩空气。随机选择的气体在活检前给予5分钟，并在活检后持续30分钟。26例采用空气（第1组），24例采用纯氧（第2组）。第2组中有4名受试者因无法维持所需的氧气呼吸而被排除在分析之外。结果显示，呼吸氧气的受试者（20例中有4例）发生气胸的情况比呼吸空气的受试者（26例中有11例）少。第1组中有3例患者因呼吸困难症状需要胸腔闭式引流，但第2组中无人需要。第2组中每个气胸的气体积聚峰值面积较小，平均表面积为27.1平方厘米（范围为9.6 - 63.8平方厘米），低于第1组的平均68.1平方厘米（范围为6.4 - 172.4平方厘米）。氧气组气胸较少这一相当令人惊讶的发现可能是由于肺穿刺后小漏气立即被快速吸收所致。这些结果具有统计学意义（p<0.05）。我们得出结论，经胸针吸活检期间呼吸100%氧气可减少气胸的数量和大小，并提出这种简单技术以降低经胸针吸肺活检的发病率。
