Brown K T, Brody L A, Getrajdman G I, Napp T E
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Radiology. 1997 Oct;205(1):249-52. doi: 10.1148/radiology.205.1.9314993.
To evaluate prospectively the feasibility of treating iatrogenic pneumothorax after fine-needle aspiration biopsy (FNAB) of the lung with short-term placement of a small-caliber chest tube and to determine whether a 1-hour clamping trial is adequate to identify patients with persistent air leak.
All patients undergoing FNAB of lung masses over a 28-month period were entered into the study. Patients with symptomatic, enlarging, or greater than 30% pneumothorax were treated with an 8-F chest tube. After 2 hours, the chest tube was clamped, and if the lung remained expanded for an additional hour, the chest tube was removed and the patients were discharged after a brief observation period. Patients were followed up by telephone after 24 hours.
Three hundred fifteen patients underwent FNAB of the lung. Sixty-eight patients (22%) developed a pneumothorax. Chest tubes were placed in 14 patients (4%): Six patients (2%) required admission to the hospital (four for air leaks), and the other eight patients were treated successfully as outpatients, with removal of the chest tube before discharge the day of FNAB.
Patients who develop clinically important pneumothorax after FNAB can be safely treated with short-term, small-caliber chest tubes and require hospital admission only if they demonstrate evidence of continued air leak.
前瞻性评估在肺细针穿刺活检（FNAB）后短期放置小口径胸管治疗医源性气胸的可行性，并确定1小时夹闭试验是否足以识别持续漏气的患者。
在28个月期间所有接受肺肿块FNAB的患者纳入本研究。有症状、气胸扩大或气胸超过30%的患者用8F胸管治疗。2小时后，夹闭胸管，如果肺再持续膨胀1小时，则拔除胸管，患者经短暂观察期后出院。24小时后通过电话对患者进行随访。
315例患者接受了肺FNAB。68例患者（22%）发生气胸。14例患者（4%）放置了胸管：6例患者（2%）需要住院（4例因漏气），其他8例患者作为门诊患者成功治疗，在FNAB当天出院前拔除胸管。
FNAB后发生具有临床意义气胸的患者可通过短期小口径胸管安全治疗，只有在有持续漏气证据时才需要住院。
