本文關鍵詞： 介入治療 鎖骨下靜脈穿刺 氣胸　出處：《介入放射學雜志》2017年11期 　論文類型：期刊論文

【摘要】：目的探討心律失常介入治療術中行鎖骨下靜脈穿刺引發(fā)氣胸的危險因素。方法回顧性分析2010年1月至2014年1月在武漢亞洲心臟病醫(yī)院接受經導管射頻消融術(RFCA)或起搏器植入術行鎖骨下靜脈穿刺的4 351例患者臨床資料。分析發(fā)生氣胸患者性別、年齡、是否伴發(fā)慢性阻塞性肺疾病(COPD)及鎖骨形態(tài)變化等臨床特征,評估是否與氣胸發(fā)生相關。結果 4 351例患者中共發(fā)生氣胸47例(1.08%),年齡12~72(47.1±18.4)歲;其中女性37例(78.7%),鎖骨與胸骨夾角60°者27例,伴有COPD者2例。女性氣胸發(fā)生率較男性明顯增加(OR=2.7,95%CI=1.4~5.2);斜形鎖骨即鎖骨與胸骨夾角60°患者氣胸風險明顯增加(OR=3.5,95%CI=1.6~7.9),伴有COPD患者氣胸概率增加(OR=2.3,95%CI=1.2~4.7)。47例中5例氣胸未予特殊處理,自行吸收,19例經胸腔穿刺抽氣緩解,23例經胸腔閉式引流緩解;均完全康復出院。結論氣胸仍是介入治療中重要臨床問題。女性、有斜形鎖骨特征或伴發(fā)COPD患者接受鎖骨下靜脈穿刺時更易發(fā)生氣胸。
[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 鹵18.4). Among them, 37 cases were female and 27 cases had 60 擄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 擄clavicle and sternum angle 60 擄) 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.
【作者單位】： 武漢市第一醫(yī)院心血管內科;武漢亞洲心臟病醫(yī)院心血管內科;
【分類號】：R541.7;R561.4

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