胸腔穿刺术

定义

胸腔穿刺术 is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest.

选择的名字

Pleural fluid aspiration; Pleural tap

How the Test is Performed

The test is done in the following way:

• You sit on a bed or on the edge of a chair or bed. Your head and arms rest on a table.
• The skin around the procedure site is cleaned. A local numbing medicine (anesthetic) is injected into the skin.
• A needle is placed through the skin and muscles of the chest wall into the space around the lungs, called the pleural space. The health care provider will likely use 超声波 to find the best spot to insert the needle.
• You may be asked to hold your breath or breathe out during the procedure.
• You should not cough, breathe deeply, or move during the test to avoid injury to the lung.
• Fluid is drawn out with the needle.
• The needle is removed and the area is bandaged.
• The fluid may be sent to a laboratory for testing (pleural fluid analysis).

How to Prepare for the Test

No special preparation is needed before the test. A 胸部x光片 or 超声波 will be done before and after the test.

How the Test will Feel

You will feel a stinging sensation when the local anesthetic is injected. You may feel pain or pressure when the needle is inserted into the pleural space.

Tell your provider if you feel 呼吸急促 或有 胸部疼痛, during or after the procedure.

Why the Test is Performed

Normally, very little fluid is in the pleural space. A buildup of too much fluid between the layers of the pleura is called a 胸腔积液.

The test is performed to determine the cause of the extra fluid and to relieve symptoms from the fluid buildup.

正常的结果

Normally the pleural cavity contains only a very small amount of fluid.

What Abnormal Results Mean

Testing the fluid will help your provider determine the cause of 胸腔积液. Possible causes include:

• 转移性癌
• 肝衰竭
• 心脏衰竭
• 蛋白质含量低
• 肾脏疾病
• Trauma or post-surgery
• Asbestos-related 胸腔积液
• Collagen vascular disease (class of diseases in which the body's immune system attacks its own tissues)
• 药物反应
• Collection of blood in the pleural space (血胸)
• 肺癌 
• Swelling and inflammation of the pancreas (胰腺炎)
• 肺炎
• Blockage of an artery in the lungs (pulmonary embolism)
• 严重 underactive thyroid gland

If your provider suspects that you have an infection, a culture of the fluid may be done to test for bacteria.

风险

风险 may include any of the following:

• 出血
• 感染
• 肺萎陷(气胸)
• Respiratory distress

注意事项

A 胸部x光片 or 超声波 is commonly done after the procedure to detect possible complications.

参考文献

勃洛克汉堡王. 胸腔穿刺术. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7日艾德. Philadelphia, PA: Elsevier; 2019:chap 9.

Ruhl TS, Good JL. 胸腔穿刺术. In: Fowler GC, Choby BA, Iyengar D, et al, eds. Pfenninger and Fowler's Procedures for 初级护理. 第四版. Philadelphia, PA: Elsevier; 2020:chap 218.