Pleural puncture is most oftendiagnostic puncture of the pleural cavity. As a rule, it accumulates fluid in various diseases, for example, in a lung tumor, in cardiac edema, in tuberculosis or pleurisy. This fact is the basis for pleural puncture. The fluid level in the cavity is determined by percussion, by radiography or by ultrasound examination of the pleural cavity. Empyema, pleurisy, intrapleural bleeding and transudate in the pleural cavity are also direct indications for the procedure.
Pleural puncture. Technique of
Диагностическая плевральная пункция проводится в dressing room or patient ward. The patient is given local anesthesia with novocaine; during the procedure, the patient assumes a sitting position with his arms back. Any diagnostic puncture often ends with therapeutic measures, namely the complete removal of pathological contents from the cavity, washing with an antiseptic and introduction of antibacterial drugs into the cavity. In the case of hemothorax, drainage is carried out with the system for the preparation of autologous blood. The first portion of the contents of the pleural cavity is assessed visually by the doctor, in order to obtain complete, more comprehensive information, the contents are sent for cytological, biochemical and bacterial research.
Pleural puncture. Possible complications
The procedure requires special skillsdoctor, and yet, even with the right approach, the patient may experience various complications during the manipulation process. This may be a sharp displacement of the mediastinum, tachycardia, collapse. In order to avoid such phenomena, the physician should carefully monitor the patient's condition and pinch the tube during a pleural puncture.
What is the purpose of a pleural puncture?
In the pleural cavity of any healthy personabout 50 ml of fluid is always present. Diseases of the lungs and pleura can lead to the fact that a puffy or inflammatory fluid accumulates between the leaves of the pleura. Since it greatly worsens the condition of the patient, it is removed during pleural puncture. If the fluid is small, it means that the patient is undergoing a diagnostic puncture, it helps to determine the presence of abnormal cells and determine the nature of the accumulated fluid.
Preparation for pleural puncture
The set for pleural puncture includesTwenty-gram syringe, needle 7-10 cm long and 1-1.2 mm in diameter and with a steeply sloping tip, it is attached to the syringe with a rubber tube. To prevent air from entering the pleural cavity, a special clamp is placed on it. A set of two to three tubes will be required to send exudate to the study, in addition to them it is necessary to have a sterile tray with tweezers, tampons, wands with cotton, as well as alcohol, iodine, collodion and ammonia in case of fainting of the patient.
Pleural puncture with pneumothorax
Spontaneous pneumothorax is also directindication for pleural puncture. The technique of carrying out this manipulation is no different from the usual one, except that during pneumothorax, air is sucked out of the pleural puncture with a syringe or pleuroaspirator. With the development of valvular pneumothorax, air during inhalation constantly enters the pleural cavity. Since there is no reverse drainage, no clamp is applied to the tube after puncture, but air drainage is left. Do not forget that after the pleural puncture of the patient should be urgently hospitalized in the surgical department.
