针刺及穴位注射致气胸38例临床分析  

Clinical analysis on 38 cases of pneumothorax induced by acupuncture or acupoint injection

作　　者：赵东勇[1] 张国良[2] 

机构地区：[1]河北省廊坊市人民医院胸外科,廊坊065000 [2]北京大学人民医院胸外科,北京100044

出　　处：《中国针灸》2009年第3期239-242,共4页Chinese Acupuncture & Moxibustion

摘　　要：目的:探讨针刺或穴位注射疗法继发气胸的发病机制及其预防方法。方法:回顾性分析38例针刺或穴位注射疗法继发气胸的初起临床征象并将其分为4型:呼吸困难型、休克型、胸痛型和迟发型。阐明各临床型与气胸严重程度的关系以及气胸造成患者死亡的机制。结果:本组报告针刺和穴位注射后发生气胸38例,其中有呼吸困难型4例、休克型16例、胸痛型14例、迟发型4例。经适当处理治疗,38例中痊愈37例,1例呼吸困难型患者死于张力性气胸。结论:针刺或穴位注射疗法继发气胸的发病机制是施针或穴位注射时将毫针或注射针头刺入肺组织内,又由于患者的呼吸动作,毫针或注射针头就像刀尖一样将肺割开,肺泡内的气体漏入胸膜腔而形成气胸。施针或穴位注射时不要将毫针或注射针头刺入肺组织内是预防继发气胸的可靠方法。Objective To probe into the mechanism of pneumothorax caused by acupuncture or acupoint injection and the preventive methods. Methods Retrospectively analyze the clinical original symptoms of 38 cases with pneumothorax caused by acupuncture and acupoint injection, which were divided into four clinical types： dyspnea type, shock type, thoracalgia type and tardy type. Illustrate the relation of the clinical types with severe degrees of pneumothorax, and the mechanism of pneumothorax inducing death of the patient. Results In the series there were 38 cases with pneumothorax induced by acupuncture or acupoint injection, including 4 cases of dyspnea type, 16 cases of shock type, 14 cases of thoracalgia type, 4 cases of tardy type. After proper treatment, 37 cases were cured and one case of dyspnea type died of tension pneumothorax. Conclusion The mechanism of pneumothorax caused by acupuncture or acupoint injection is that due to the filiform needle tip or the syringe’s needle tip inserting into the lung tissue at the patient’s respiration in acupuncture or acupoint injection, the filiform needle tip or the syringe’s needle tip lacerates the lung tissue. Air in alveolus goes into the thorax pleura cavity to form pneumothorax. In acupuncture or acupoint injection, the needle tip must not insert into the lung tissue, which is a key for prevention of pneumothorax.

关 键 词：针灸意外 水针 气胸 刺法 

分 类 号：R246[医药卫生—针灸推拿学]