What does a chest puncture check?

Chest puncture is also a common examination method. It mainly involves piercing the skin with some sterilized needles and entering the pleural cavity. It is a relatively simple treatment and diagnosis method. Through such an examination, the patient's pleural effusion can be detected. This method can be used to extract the effusion and conduct a careful examination to find the cause of the disease and carry out symptomatic treatment.

What does a chest puncture check?

First of all, we should know the role of thoracentesis in the diagnosis and treatment of thoracic diseases. In the clinical work of pulmonary medicine, thoracentesis is a common, convenient and simple diagnostic and treatment method.

For example: Through examination, we found that there was fluid accumulation in the patient's pleural cavity. We can extract the fluid through thoracentesis and conduct various examinations to find the cause of the disease. If there is a lot of fluid in the cavity, compressing the lungs or the fluid accumulates for too long, the fibrin in it will easily become sclerotic and cause the two layers of pleura to adhere, thus affecting the respiratory function of the lungs. At this time, we also need to puncture and drain the accumulated fluid.

If necessary, drugs can be injected to achieve therapeutic purposes. For example, if pleural effusion is caused by cancer, we inject anti-cancer drugs to play an anti-cancer effect. If there is too much gas in the chest cavity and the pleural cavity has changed from negative pressure to positive pressure, then this operation can also be used to reduce the pressure and draw out the gas.

If the patient's bronchus and pleural cavity are connected, we will inject a blue drug (called methylene blue, which is harmless to the human body) into the chest cavity through a puncture needle. Then, the patient will cough up blue liquid (including sputum) when coughing. At this time, we can confirm that the patient has bronchopleural fistula. Bronchopleural fistula is a pathological channel established when lung lesions involve the bronchi, alveoli and pulmonary pleura. It is a channel that runs through the mouth → trachea → bronchi at all levels → alveoli → visceral pleura → pleural cavity.

Precautions

(1) Patients with coagulation defects, bleeding diseases, or those taking anticoagulant drugs should be treated accordingly before undergoing this surgery. (2) Adequate anesthesia should be provided at the thoracotomy site to prevent the occurrence of pleural shock. (3) The needle should be inserted close to the upper edge of the ribs to avoid injuring the intercostal blood vessels and nerves. Needles, latex tubes or three-way switches, syringes, etc. should be kept airtight to prevent air from entering the chest and causing pneumothorax. (4) The puncture should be performed carefully, the technique should be skillful, and the disinfection should be strict to avoid causing new infection, pneumothorax, hemothorax, or accidental injury to blood vessels, heart, liver, and spleen. (5) Avoid coughing during the puncture process. And the patient's changes should be observed at any time. If you experience pale face, sweating, dizziness, palpitations, or weak pulse, stop puncture immediately. Let the patient lie flat, give him oxygen inhalation if necessary, and inject epinephrine or sodium benzoate caffeine subcutaneously. In addition, appropriate treatment should be given according to the condition.