Clinical Analysis of Iatrogenic Pneumothorax

의인성 기흉에 대한 임상 고찰

  • Choi, Si-Young (Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medical Medicine) ;
  • Moon, Mi-Hyoung (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medical Medicine) ;
  • Kwon, Jong-Bum (Department of Thoracic and Cardiovascular Surgery, Daejeong St. Mary's Hospital, The Catholic University of Korea College of Medical Medicine) ;
  • Kim, Yong-Hwan (Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medical Medicine)
  • 최시영 (가톨릭대학교 의과대학 의정부성모병원 흉부외과학교실) ;
  • 문미형 (가톨릭대학교 의과대학 서울성모병원 흉부외과학교실) ;
  • 권종범 (가톨릭대학교 의과대학 대전성모병원 흉부외과학교실) ;
  • 김용환 (가톨릭대학교 의과대학 의정부성모병원 흉부외과학교실)
  • Published : 2009.12.05

Abstract

Background: This study was designed to determine etiologic factors for iatrogenic pneumothorax in an era of in-creased use of invasive procedures and to evaluate its impact on morbidity. Material and Method: Subjects were 112 patients (65 men and 47 women ranging in age from 20 to 90 years) who were diagnosed with an iatrogenic pneumothorax between January 2005 and December 2008. We reviewed medical records retrospectively. Result: The leading causes of iatrogenic pneumothorax were percutaneous needle aspiration (50), central venous catheterization (29), acupuncture (14), thoracentesis (8) and positive pressure ventilation (7). The majority of the patients (60 of 114) were treated with chest tubes. The mean duration of hospital treatment was 5.8 $({\pm}4.0)$ days. Hospitalization was prolonged in 24 patients (21.1%). No patient died from iatrogenic pneumothorax. Conclusion: In our study, the most common cause of Iatrogenic pneumothorax was percutaneous needle aspiration. The mortality and morbidity from iatrogenic pneumothorax is not significant. The recognition of pneumothorax, depends on careful examination after completion of an invasive procedure, and should be followed by prompt and definitive therapy.

배경: 이 연구를 통해 침습적인 시술이 증가 함에 따른 의인성 기흉의 원인과 그에 따른 이환율을 알고자 한다. 대상 및 방법: 2005년 1월부터 2008년 12월까지 의인성 기흉의 진단으로 입원치료를 받은 112명의 환자(20세부터 90세까지의 연령분포를 보인 65명의 남자 환자와 47명의 여자 환자)에게서 후향적으로 의무기록을 조사하였다. 결과: 의인성 기흉의 호발 원인은 경피적 폐생검(50), 중심정맥관 삽입(29), 침술(14), 흉수천자(8), 양압환기(7)의 순서였다. 60명의 환자에서 흉관삽관술을 통해 치료하였다. 평균 치료 기간은 5.8 $({\pm}4.0)$일이었다. 24명의 환자에서 재원 기간이 길어졌으며, 의인성 기흉으로 인한 사망은 없었다. 결론: 이 연구에서는 의인성 기흉의 가장 흔한 원인은 경피적 폐생검이었다. 이에 따른 사망률이나 이환율은 미미한 수준이었다. 의인성 기흉의 진단에 있어 침습적인 시술 이후의 신중한 검사 및 그에 따른 치료가 중요할 것으로 생각된다.

Keywords

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