Yankelevitz D F, Davis S D, Henschke C I
Department of Radiology, New York Hospital-Cornell Medical Center, New York 10021, USA.
Radiology. 1996 Sep;200(3):695-7. doi: 10.1148/radiology.200.3.8756917.
To determine whether simple aspiration of air from the pleural space could obviate chest tube placement in patients with a large pneumothorax after transthoracic needle biopsy.
Seventeen patients, who developed a large pneumothorax (> 30%) during computed tomographic (CT)-guided transthoracic needle biopsy and otherwise would have required chest tube placement, underwent percutaneous aspiration of the pneumothorax while on the CT scanner table. Air was aspirated from the pleural space by using an 18-gauge intravenous catheter attached to a three-way stopcock and a 50-mL syringe. The patients were positioned with the puncture site down after aspiration of the pneumothoraces and oxygen was administered both during and after the procedure.
The pneumothorax was almost completely aspirated in all 17 patients. Twelve (70%) patients did not require chest tube placement. Follow-up chest radiographs obtained 2 and 4 hours after the procedure revealed complete or almost complete resolution of the pneumothorax in eight (47%) patients and partial recurrence of a small, stable pneumothorax in four (24%) patients. The remaining five (29%) patients had recurrence of their pneumothorax, which ultimately required chest tube placement.
Percutaneous catheter aspiration of a large biopsy-induced pneumothorax is safe and easy to perform and may obviate chest tube placement.
确定对于经胸针吸活检后出现大量气胸的患者，单纯从胸腔抽出空气是否可避免放置胸管。
17例在计算机断层扫描（CT）引导下经胸针吸活检期间出现大量气胸（>30%）且否则需放置胸管的患者，在CT扫描台上接受了气胸的经皮抽吸。使用连接三通旋塞和50毫升注射器的18号静脉导管从胸腔抽出空气。气胸抽吸后患者穿刺部位朝下安置，并在操作期间及之后给予氧气。
所有17例患者的气胸几乎完全被抽出。12例（70%）患者无需放置胸管。操作后2小时和4小时获得的胸部X线片显示，8例（47%）患者的气胸完全或几乎完全消退，4例（24%）患者出现小的、稳定的气胸部分复发。其余5例（29%）患者气胸复发，最终需要放置胸管。
经皮导管抽吸活检引起的大量气胸安全且易于操作，可能避免放置胸管。
