锁骨下静脉穿刺致47例气胸原因分析

发布时间：2018-02-22 05:59

本文关键词： 介入治疗锁骨下静脉穿刺气胸　出处：《介入放射学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨心律失常介入治疗术中行锁骨下静脉穿刺引发气胸的危险因素。方法回顾性分析2010年1月至2014年1月在武汉亚洲心脏病医院接受经导管射频消融术(RFCA)或起搏器植入术行锁骨下静脉穿刺的4 351例患者临床资料。分析发生气胸患者性别、年龄、是否伴发慢性阻塞性肺疾病(COPD)及锁骨形态变化等临床特征,评估是否与气胸发生相关。结果 4 351例患者中共发生气胸47例(1.08%),年龄12~72(47.1±18.4)岁;其中女性37例(78.7%),锁骨与胸骨夹角60°者27例,伴有COPD者2例。女性气胸发生率较男性明显增加(OR=2.7,95%CI=1.4~5.2);斜形锁骨即锁骨与胸骨夹角60°患者气胸风险明显增加(OR=3.5,95%CI=1.6~7.9),伴有COPD患者气胸概率增加(OR=2.3,95%CI=1.2~4.7)。47例中5例气胸未予特殊处理,自行吸收,19例经胸腔穿刺抽气缓解,23例经胸腔闭式引流缓解;均完全康复出院。结论气胸仍是介入治疗中重要临床问题。女性、有斜形锁骨特征或伴发COPD患者接受锁骨下静脉穿刺时更易发生气胸。
[Abstract]:Objective to investigate the risk factors of pneumothorax induced by subclavian vein puncture during interventional therapy of arrhythmia. Methods from January 2010 to January 2014, radiofrequency catheter ablation (RFCA) or radiofrequency catheter ablation (RFCA) or. The clinical data of 4 351 patients undergoing subclavian vein puncture during pacemaker implantation were analyzed. Age, chronic obstructive pulmonary disease (COPD) and changes in clavicle morphology were evaluated to evaluate the correlation between pneumothorax and pneumothorax. Results there were 47 patients with pneumothorax in 47 patients (age 127247.1 卤18.4). Among them, 37 cases were female and 27 cases had 60 掳angle between clavicle and sternum. There were 2 cases with COPD. The incidence of pneumothorax in women was significantly higher than that in males. The risk of pneumothorax in patients with oblique clavicle (60 掳clavicle and sternum angle 60 掳) was significantly increased. The probability of pneumothorax in patients with COPD was increased by OR2.395CI1.24.70.The pneumothorax was not specially treated in 5 cases. 19 cases of spontaneous absorption of pneumothorax were relieved by thoracocentesis and 23 cases were relieved by closed drainage of thoracic cavity. Conclusion pneumothorax is still an important clinical problem in interventional therapy. Pneumothorax is more likely to occur in patients with oblique clavicle or with COPD under subclavian vein puncture.
【作者单位】：武汉市第一医院心血管内科;武汉亚洲心脏病医院心血管内科;
【分类号】：R541.7;R561.4

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