Matters needing attention of pleural puncture needle

1. The purpose of puncture should be explained to the patient before operation to remove concerns, and informed consent should be signed; For nervous patients, diazepam 10mg or codeine 0.03g can be given half an hour before the operation to calm the pain.

2. Patients' reactions should be closely observed during the operation, such as dizziness, pallor, sweating, palpitations, chest pressure or severe pain, syncope and other pleural allergic reactions; Or when there is continuous cough, shortness of breath, foaming sputum and other phenomena, immediately stop pumping fluid, and subcutaneous injection of 0.1% epinephrine 0.3-0.5ml, or other symptomatic treatment.

3. Do not pump too much or too fast at one time. Diagnostic fluid extraction, 50 to 100ml. Vacuum pump, not more than 600ml for the first time, and not more than 1000ml for each subsequent time. Such as empyema, every time as far as possible to extract, suspected suppurative infection, assistant with aseptic test tube to collect specimens, smear gram staining microscopy, bacterial culture and drug sensitivity test. At least 100ml of tumor cells should be examined and should be submitted immediately to avoid cell autolysis.

4. Strict aseptic operation should always keep negative pleural pressure during operation to prevent air from entering the chest cavity.

5. Puncture below the 9th intercostal space should be avoided to avoid penetrating the diaphragm and damaging the abdominal organs.

6. The patient's vital signs were measured before and after the operation, and the patient was instructed to lie down and rest for 30 minutes after the operation.

7. For malignant pleural effusion, anti-tumor drugs or hardeners can be injected to induce chemical pleuritis, so as to promote adhesion between the visceral layer and the parietal pleura, close the chest and prevent the re-accumulation of pleural fluid. Specific operation: After extraction of 500-1200ml, the drug (such as minocycline 500mg) was diluted with normal saline 20-30 and injected. After the drug is pushed, the chest fluid is pumped back, and then pushed back, repeated 2-3 times, the patient is told to stay in bed for 2-4 hours, and constantly change the body position, so that the drug is evenly coated in the chest. If the injected drug is highly irritating and may cause chest pain, analgesics such as tondrin or pethidine should be administered before the medication.

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