鎖骨下腋靜脈置入中央靜脈導管引發氣胸病例報告

Pneumothorax after Central Venous Cannulation via the Infradavicular Axillary Vein — A Case Report

以前文獻沒有鎖骨下腋靜脈置入中央靜脈導管引發氣胸的報告。本院在數月前，發生一位接受腦瘤切除手術的66歲婦女，因鎖骨下腋靜脈置入中央靜脈導管引發氣胸併發症。這件併發症並沒有立即被查覺，直至術後的胸部X光才給予確定診斷。我們以相關的解剖構造來探討它可能的發生原因；並就如何預防氣胸，提出以前相關文獻沒有提到的觀點。

It has ever been reported that central venous cannulation via the infraclavicular axillary vein (IAV) could cause pneumothorax. However, recently at our hospital, a 66-year-old female patient undergoing craniectomy for brain tumor sustained pneumothorax after cannulation of the IAV for intraoperate monitoring. The complication was not recognized until a postoperative chest X-ray had been taken. The departmental panel on morbidity reviewed the anatomy of the infraclavicular area to explore the possible causes of the incident. As to prevention of pneumo-thorax, we also bring forward some important points for discussion that have not been discoursed in previous reports.