PDF(Pubmed)
Abstract：
BACKGROUND: Hemothorax is a rare but life-threatening complication of central venous catheterization. Recent reports suggest that ultrasound guidance may reduce complications however, it does not guarantee safety.
METHODS: A 75-year-old male patient was admitted for laparoscopic radical nephrectomy. Under ultrasound guidance, right internal jugular vein catheterization was successfully achieved after failure to aspirate blood from the catheter in the first attempt. Sudden hypotension developed after surgical positioning and persisted until the end of the operation, lasting for about 4 h. In the recovery room, a massive hemothorax was identified on chest radiography and computed tomography. The patient recovered following chest tube drainage of 1.6 L blood.
CONCLUSIONS: Hemothorax must be suspected when unexplained hemodynamic instability develops after central venous catheterization despite ultrasound guidance. So the proper use of ultrasound is important.
METHODS: A 75-year-old male patient was admitted for laparoscopic radical nephrectomy. Under ultrasound guidance, right internal jugular vein catheterization was successfully achieved after failure to aspirate blood from the catheter in the first attempt. Sudden hypotension developed after surgical positioning and persisted until the end of the operation, lasting for about 4 h. In the recovery room, a massive hemothorax was identified on chest radiography and computed tomography. The patient recovered following chest tube drainage of 1.6 L blood.
CONCLUSIONS: Hemothorax must be suspected when unexplained hemodynamic instability develops after central venous catheterization despite ultrasound guidance. So the proper use of ultrasound is important.
摘要：
背景：血胸是中心静脉导管插入术的一种罕见但危及生命的并发症。最近的报道表明，超声引导可以减少并发症。它不能保证安全。
方法：一名75岁男性患者接受腹腔镜肾癌根治术。在超声引导下,在第一次尝试从导管抽吸血液失败后,成功实现了右颈内静脉置管.手术定位后突然出现低血压，并持续到手术结束，持续约4小时。在恢复室，在胸部X线摄影和计算机断层扫描中发现了大量血胸.患者在胸管引流1.6L血液后康复。
结论：在超声引导下，当中心静脉导管插入后出现无法解释的血流动力学不稳定时，必须怀疑血胸。因此，正确使用超声波很重要。
方法：一名75岁男性患者接受腹腔镜肾癌根治术。在超声引导下,在第一次尝试从导管抽吸血液失败后,成功实现了右颈内静脉置管.手术定位后突然出现低血压，并持续到手术结束，持续约4小时。在恢复室，在胸部X线摄影和计算机断层扫描中发现了大量血胸.患者在胸管引流1.6L血液后康复。
结论：在超声引导下，当中心静脉导管插入后出现无法解释的血流动力学不稳定时，必须怀疑血胸。因此，正确使用超声波很重要。
