Views: 17 Author: Site Editor Publish Time: 2024-11-25 Origin: Site
Thoracentesis is a procedure in which a sterilized needle is passed through the skin, intercostal tissue and pleural wall into the pleural cavity. In the clinical work of the respiratory department, thoracentesis is a common, simple and easy-to-operate diagnostic and treatment method.
However, many patients are afraid of thoracentesis. Compared with the decompression needle in the buttocks, it is psychologically difficult to accept the operation of piercing the chest cavity, which is close to the heart and lungs. Understanding the patient's precautions and how to cooperate with the doctor can effectively reduce the risk of surgery. In fact, the risk of thoracentesis is almost negligible if it is performed according to the operating procedures. Therefore, we can assume that thoracentesis is safe and patients do not need to worry too much.
When performing thoracentesis, the operator must master some key knowledge, including the indications for thoracentesis, the key points of operation, and the correct use of the decompression needle. It is particularly important to emphasize that the decompression needle must be inserted along the upper edge of the ribs, and must not be inserted into the lower edge of the ribs, because there are blood vessels and nerves at the lower edge, and accidental injury to these structures may cause serious complications.
In addition, operators should also pay attention to strict disinfection, maintain a sterile environment in the operation area, and avoid cross infection. At the same time, during the operation, the patient should be emotionally stable, relieve anxiety, and cooperate closely with the doctor. If necessary, the operation should be stopped immediately and emergency treatment should be performed when abnormal conditions occur.
Patients should cooperate closely with doctors during thoracentesis to eliminate fear, anxiety, and tension. Before the operation, patients should not cough violently, and it is best to stay in bed and rest to avoid excessive fatigue or tension. If you feel uncomfortable, you should inform the doctor in time so that the doctor can adjust the operation plan or consider suspending the operation. After the operation, the patient should lie still for two hours and avoid strenuous activities.
Lung puncture is actually a deeper operation of thoracentesis, which enters the lungs through the pleural cavity and visceral pleura. There are two purposes for this operation: first, to perform a lung tissue biopsy and draw fluid samples from the thoracic cavity or bronchial cavity for further examination to clarify the diagnosis; second, it is used to treat some diseases, such as draining pus and injecting drugs. However, the operation of lung puncture requires more precision, and the operator must be more careful to shorten the puncture time as much as possible and reduce damage to lung tissue. During the operation, the patient needs to cooperate closely with the doctor, maintain stable breathing, avoid violent coughing, and conduct a detailed examination before puncture to ensure accurate positioning, thereby increasing the success rate of puncture.
Operation process of thoracentesis
Patient preparation: First, ask the patient to sit on a chair, facing the back of the chair, with both arms on the back of the chair and the forehead resting on the arms. For patients who cannot sit up, they can be placed in a semi-recumbent position with the upper arm on the affected side placed on the pillow.
Marking the puncture point: According to the percussion results, choose the most prominent and solid part of the chest as the puncture point. Then, use a cotton swab dipped in methylene blue (or gentian violet) to mark the puncture point.
Disinfection operation: Perform routine disinfection on the puncture site, wear sterile gloves, and cover with a sterile sheet.
Local anesthesia: Use 2% lidocaine for local anesthesia, and anesthetize the puncture point from the skin to the pleural wall.
Puncture operation: The operator uses the index and middle fingers of the left hand to fix the skin at the puncture site, and tightens the nut of the decompression needle with the right hand, and slowly inserts the needle into the anesthesia area. When the resistance of the needle suddenly disappears, unscrew the nut, open the needle, and enter the pleural cavity for suction. The assistant uses hemostatic forceps to fix the puncture needle to avoid excessive puncture and injury to lung tissue. After extracting enough fluid, rotate the nut to open it and drain the fluid.
End of the operation: After the puncture, remove the decompression needle, cover it with sterile gauze and apply pressure to stop bleeding, and finally fix the wound with tape. The patient should lie flat and rest.
As long as the doctor strictly follows the operating procedures and the patient can eliminate fear and cooperate with the doctor, thoracentesis is very safe. The risk of the puncture operation itself is extremely low, and the patient does not need to worry too much. Throughout the process, maintaining the accuracy of the operation and meticulous care, as well as the active cooperation of the patient, is the key to ensuring the success of the operation.
