Indications and contraindications for thoracentesis

Thoracentesis is actually a puncture of the pleural cavity. For some patients with gas or fluid in the chest cavity, thoracentesis can be used for treatment. Thoracentesis is widely used in many treatments because of its mature technology and few side effects on patients. However, not all patients can undergo thoracentesis. The indications and contraindications for thoracentesis are as follows:

The main role of thoracentesis

① Take pleural effusion for general characteristics testing, chemical testing, microscopic monitoring and bacteriological testing to clarify the nature of the effusion and find the cause of the effusion;

② Drain the pleural effusion and gas accumulation to reduce the pressure of the liquid and gas on the lung tissue, so that the lung tissue can be expanded again and the patient's symptoms such as dyspnea can be relieved;

③ Aspirate pus from the pleural cavity, perform pleural lavage, and treat empyema;

④ Intrapleural administration: antibiotics or anticancer drugs can be injected into the pleural cavity.

Indications

1. Diagnostic: For pleural effusion of unknown cause, diagnostic puncture can be performed, and pleural effusion smear, culture, cytology and biochemical examination can be performed to clarify the cause, and the lung condition can be examined.

2. Therapeutic: Treat unilateral or bilateral pleural effusion, compression caused by gas accumulation, dyspnea and other symptoms by draining fluid, evacuating gas or decompressing the chest cavity; inject drugs into the chest cavity (anti-tumor drugs or drugs that promote pleural adhesion, etc.).

Contraindications

1﹒ Patients with weak constitution, critical condition and difficulty in enduring puncture.

2. Allergic to anesthetics.

3﹒ Patients with coagulation disorders and severe bleeding tendency should not be punctured before they are corrected.

4﹒ Those with mental illness or who are uncooperative.

5﹒ For patients suspected of having thoracic echinococcosis, puncture may cause the spread of infection and is not recommended.

6﹒ Infection at or near the puncture site.

Preoperative preparation

1. Understand and be familiar with the patient's condition.

2. Talk to the patient's family, explain the purpose of the examination, the general process, possible complications, etc., and have them sign.

3. Instrument preparation: thoracentesis kit, sterile chest drainage tube and drainage bottle, skin disinfectant, anesthetic, sterile cotton balls, gloves, drapes, syringes, gauze and adhesive tape.