Why do we need a pleural puncture?
Pleural puncture is most often adiagnostic puncture of the pleural cavity. As a rule, liquid accumulates in it for various diseases, for example, for a lung tumor, for cardiac edema, for tuberculosis or pleurisy. This fact is the basis for pleural puncture. The level of fluid in the cavity is determined by percussion, radiography or ultrasound examination of the pleural cavity. An empyema of the pleura, pleurisy, intrapleural bleeding and a transudate in the pleural cavity are also direct indications for the procedure.
Pleural puncture. Techniques for conducting
Diagnostic pleural puncture is performed indressing or in the patient's ward. The patient is given local anesthesia with novocaine, during the procedure the patient assumes a sitting position with the arms withdrawn back. Any diagnostic puncture is most often completed by medical measures, namely the complete removal of pathological contents from the cavity, washing with an antiseptic and introducing antibacterial drugs into the cavity. In the case of hemothorax, drainage is carried out with a system for harvesting autologous blood. The first portion of the contents from the pleural cavity is evaluated by the physician visually, in order to obtain complete more comprehensive information, the content is sent to a cytological, biochemical and bacterial study.
Pleural puncture. Possible complications
The procedure requires special skills ina doctor, and yet, even with a competent approach, the patient may experience various complications during manipulation. It can be a sharp displacement of the mediastinum, tachycardia, collapse. To avoid such phenomena, the doctor must carefully monitor the patient's condition and during the pleural puncture, clamp the tube with a clamp.
What is the purpose of pleural puncture?
In the pleural cavity of any healthy personAbout 50 ml of liquid is constantly stored. Diseases of the lungs and pleura can lead to the fact that between the leaves of the pleura accumulates edematous or inflammatory fluid. Since it greatly worsens the patient's condition, it is removed by pleural puncture. If there are few liquids, then the patient is made a diagnostic puncture, it helps to determine the presence of pathological cells and determine the nature of the accumulated fluid.
Preparing for pleural puncture
A set for pleural puncture includesa twenty-gram syringe, an igloo 7-10 cm long and 1-1.2 mm in diameter and with a steeply tapered point, it joins the syringe with a rubber tube. To prevent air from entering the pleural cavity during the procedure, a special clamp is placed on it. A set of two or three tubes is required to send the exudate to the study, in addition to them it is necessary to have a sterile tray with tweezers, tampons, wands with cotton wool, as well as alcohol, iodine, collodion and ammonia in case of syncope in the patient.
Pleural puncture with pneumothorax
Spontaneous pneumothorax is also a directindication for pleural puncture. The technique of carrying out this manipulation is no different from the usual one, except that when pneumothorax from the pleural puncture, air is sucked off with a syringe or pleuroasciration. With the development of valve pneumothorax, air constantly enters the pleural cavity during inspiration. Since there is no reverse drainage, the tube is not applied to the tube after the puncture, but the air drainage is left. Do not forget that after a pleural puncture the patient should be urgently hospitalized in the surgical department.