What conditions require lung puncture?

Lung puncture is also a relatively common examination method. For some suspected tumors, this method can be used for diagnosis and examination. It should be noted that when doing lung puncture examination, you must understand some precautions. After the operation, you must strengthen care to prevent the occurrence of complications, such as pneumothorax, air embolism, etc., to prevent the occurrence of these symptoms.

What conditions require lung puncture?

Repeated sputum cytology tests are all negative; when the supraclavicular metastatic lymph nodes are too deep to be punctured, or the tumor is too close to the chest wall for bronchoscope to reach, or the patient cannot tolerate bronchoscopy, and the tumor is located in a suitable location for puncture, lung puncture is required to confirm the pathological diagnosis.

Does lung puncture require hospitalization?

1. For lesions of the upper lobe and hilum, puncture is usually performed from the front in the supine position. For lesions of the lingula and middle lobe, puncture is usually performed from the side in the supine position. For lesions of the basal segment and dorsal segment of the lower lobe, puncture is usually performed from the back in the prone position. The center of the lesion is selected as the puncture level, and the puncture route is the shortest distance from the skin to the lesion (vertical or horizontal distance), and care is taken to avoid blood vessels, interlobar fissures, and intercostal nerves. When the lesion is located in the posterior segment of the upper lobe apex, an oblique needle insertion is sometimes used to avoid the scapula and ribs.

2. Select the puncture point and path according to the location and size of the lesion shown by CT or fluoroscopy, and mark the puncture point with a marker pen or gentian violet. The skin at the puncture area is routinely disinfected, covered with a drape, and local anesthesia is performed. Under the guidance of CT or fluoroscopy, the puncture needle is inserted into the lesion, and the patient is asked to hold his breath during needle insertion. After CT or fluoroscopy confirms that the puncture needle tip is in the center of the lesion and there is no necrotic area, pull out the needle core, connect the syringe for negative pressure suction, and pull up the puncture needle to perform multi-point fan-shaped sampling. For solid masses, a cutting needle can be used to obtain specimens, which can then be sent for pathological examination.

Lung puncture precautions

1. Postoperative care: Patients need to be observed for 2 to 4 hours after the puncture biopsy. If no abnormalities are found by fluoroscopy, radiography or CT scan, they can go home for observation.

2. Complications ① Pneumothorax: The most common complication. If the lungs are compressed by 20% and symptoms tend to worsen, chest venting treatment is required. ② Bleeding: Mild hemoptysis, advise to rest in bed, take diazepam orally or intramuscularly. Massive hemoptysis can be treated with hemostatic drugs such as vasopressin. ③Air embolism: rare but with serious consequences. During the operation, care should be taken to prevent penetration of the pulmonary vessels, and the cannula needle should be blocked with the needle stylet immediately after each aspiration to prevent air from entering. ④ Tumor metastasis: rare. The needle core should be properly protected by a cannula when the needle is removed to prevent the biopsy material from falling off along the needle track.