[申覆] 醫學一 (24)
24 下列關於胸腔穿刺（thoracentesis）敘述何者錯誤？
(A)需避開肋骨下緣之肋間神經、血管（intercostal nerve, vessel）
(B)穿刺時需在吐氣（expiration）時進行
(C)一般在第九肋間穿刺最適當
(D)常在鎖骨中線（midclavicular line）位置進行穿刺
答案: D
建議答案: C 或 D
佐證資料:
Manual of Intensive Care Medicine, 5th Edition
Editors: Irwin, Richard S.; Rippe, James M.
Copyright c (C)2010,2006,2000 Lippincott Williams & Wilkins
I - Procedures and Techniques > 10 - Thoracentesis > III. Procedure >
p.58
A. Technique for Diagnostic (Needle Only or Catheter-Over-Needle)
Removal of Freely Flowing Fluid
step 4. With the patient sitting, arms at side, mark the inferior tip of the
scapula on the side to be tapped. This approximates the eighth intercostal
space, the lowest level that may be safely punctured unless previous
sonography determined that a lower interspace can safely be entered.
p.59
B. Technique for Therapeutic Removal of Freely Flowing Fluid
Follow steps 1 to 8 as described previously.
依據引文所述 應以第八肋間進行穿刺較為恰當
第九肋間須確定確實安全無虞方使用
故建議答案C亦開放
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