针灸致双侧大量气胸诊治体会  

Experience in diagnosis and treatment of bilateral pneumothorax caused by acupuncture

作　　者：吴建辉 邓新宇 刘志新 赖子彪 薛青 Wu Jianhui;Deng Xinyu;Liu Zhixin;Lai Zibiao;Xue Qing(Department of Respiratory and Critical Care Medicine,Ningde Municipal Hospital of Fujian Medical University,Ningde 352100,Fujian,China)

机构地区：[1]福建医科大学附属宁德市医院呼吸与危重症医学科,福建宁德352100

出　　处：《中国中西医结合急救杂志》2019年第6期739-742,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的 分析针灸引起双侧气胸患者的临床特征,以期提高临床医师对针灸治疗引起双侧气胸不良反应的认识.方法 回顾性分析福建医科大学附属宁德市医院成功救治1例针灸引起双侧大量气胸患者的临床资料,以"针灸,双侧气胸"为中文关键词分别检索中国知网数据库、维普数据库、万方数据库,以"acupuncture,bilateral pneumothorax"为英文关键词检索Pubmed数据库的相关文献,检索时间截至2017年10月,对检索病例资料进行分析.结果 患者女性,43岁,因颈背部酸痛至当地诊所针灸治疗,随后出现胸痛、气短,遂至本院就诊.就诊查体:呼吸频率35次/min,脉搏血氧饱和度(SpO2)0.79,口唇、四肢末端轻度发钳,双肺呼吸音微弱,胸部CT示双侧大量气胸,左肺压缩约75%,右肺压缩约80%.确诊双侧气胸后给予双侧胸腔闭式引流3 d后,复查胸部CT示双肺基本复张,胸痛、气短缓解,共住院5 d出院.文献复习共获得具有较完整临床资料文献12篇,其中中文2篇,英文10篇,加上本例,共14例针灸引起双侧气胸;男性3例,女性11例;年龄28~77岁;死亡3例,治愈11例.呼吸困难、气促或气短13例,胸痛9例.13例经胸部影像学检查明确诊断, 10例给予胸腔闭式引流后痊愈出院,1例经吸氧等保守治疗后痊愈.结论 针灸引起双侧气胸不良反应临床罕见,多以呼吸困难、胸痛为表现,严重者可迅速出现心搏骤停,胸部影像学检查可明确诊断为针灸并发气胸,及时给予胸腔闭式引流疗效果良好.因此临床医生应警惕针灸造成不良反应的风险.Objective To analyze the clinical characteristics of bilateral pneumothorax caused by acupuncture,and to improve clinicians'understanding of the adverse reactions of bilateral pneumothorax caused by acupuncture.Methods The clinical data of a patient with bilateral large pneumothorax caused by acupuncture admitted to Ningde Municipal Hospital of Fujian Medical University were retrospectively analyzed.A literature research was performed respectively in China National Knowledge Infrastructure(CNKI)database,VIP database,Wanfang database and Pubmed with"acupuncture,bilateral pneumothorax"as keywords,the search time was up to October 2017,and the data were analyzed.Results A 43-year-old woman complained of chest pain and shortness of breath after receiving acupuncture treatment at local clinic due to soreness of neck and back.Subsequently,she was transferred to our hospital.The patient's vital signs were as follows:respiratory rate of 35 bpm;percutaneous oxygen saturation(SpO2)of 0.79;mild cyanosis on the lips and limbs;significantly decreased breath sounds on both lungs.Chest CT revealed a large amount of pneumothorax on both sides,with compression of about 75%in the left lung and 80%in the right lung.Chest drains were inserted to both pleural cavities after diagnosis of bilateral pneumothorax and were removed on day 3.She recovered uneventfully with no residual deficit after 5 days in hospital.After the diagnosis of bilateral pneumothorax,the closed drainage of bilateral thoracic cavity was given for three days.The reexamination of chest CT showed that both lungs were basically relaunched,chest pain and shortness of breath were relieved,and they were discharged from hospital for 5 days.Literature review found 12 articles with almost complete clinical information,including 2 articles in Chinese and 10 articles in English.In addition to this case,there were 14 cases of bilateral pneumothorax caused by acupuncture,including 3 males and 11 females,ranging from 28 to 77 years old,with 3 cases dead and 11 cases cured.The c

关 键 词：针灸 双侧气胸 文献学习 

分 类 号：R24[医药卫生—中医临床基础]