Fatal bilateral pneumothoraces after electroacupuncture treatment: A case report and literature review
Fatal bilateral pneumothoraces after electroacupuncture treatment: A case report and literature review
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DOI：
10.1111/1556-4029.14874
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发表时间：
2021-08
影响因子：
1.6
通讯作者：
Rutsuko Yamaguchi;Y. Makino;S. Torimitsu;F. Chiba;Yuko Kihara;H. Iwase
中科院分区：
文献类型：
--
作者：
Rutsuko Yamaguchi;Y. Makino;S. Torimitsu;F. Chiba;Yuko Kihara;H. Iwase
针灸在世界范围内作为一种补充医学进行实践。尽管它被认为是一种安全的做法，但气胸是其最常见的严重并发症之一。然而，针灸治疗后因气胸死亡的报道很少，尤其是电针治疗。我们报告一例尸检病例，一名60多岁的男子在接受电针治疗后出现心肺骤停并立即死亡。死后计算机断层扫描（PMCT）显示双侧气胸，以及皮下嵌入大量金线。尸检发现，右胸腔有两处瘀斑，右肺下叶有一个针孔损伤，表明针头已刺入肺部。肺部出现明显的肺气肿变化，表明肺大泡破裂也可能导致双侧气胸和致命结果。由于电脉冲和肌肉收缩，针灸针可能比插入时更深入体内，这表明需要仔细确定治疗适应症和技术安全措施，例如故障安全机制。这是英文文献中报道的首例电针后致死性双侧气胸的病例报告。这个案例揭示了电针的安全性，以及对气胸风险较高的肺部疾病患者进行电针治疗时需要特别护理的必要性。这也是首次报道三维重建PMCT图像显示嵌入金针线的全身分布，这是不寻常的。
Acupuncture is practiced as a complementary medicine worldwide. Although it is considered a safe practice, pneumothorax is one of its most common serious complications. However, there have been few reports of deaths due to pneumothorax after acupuncture treatment, especially focused on electroacupuncture. We report an autopsy case of a man in his 60s who went into cardiopulmonary arrest and died immediately after receiving electroacupuncture. Postmortem computed tomography (PMCT) showed bilateral pneumothoraces, as well as the presence of numerous gold threads embedded subcutaneously. An autopsy revealed two ecchymoses in the right thoracic cavity and a pinhole injury on the lower lobe of the right lung, suggesting that the needles had penetrated the lung. There were marked emphysematous changes in the lung, suggesting that rupture of bullae might also have contributed to bilateral pneumothoraces and fatal outcome. The acupuncture needles may have been drawn deeper into the body than at the time of insertion due to electrical pulses and muscle contraction, indicating the need for careful determination of treatment indications and technical safety measures, such as fail‐safe mechanisms. This is the first case report of fatal bilateral pneumothoraces after electroacupuncture reported in the English literature. This case sheds light on the safety of electroacupuncture and the need for special care when administering it to patients with pulmonary disease who may be at a higher risk of pneumothorax. This is also the first report of three‐dimensional reconstructed PMCT images showing the whole‐body distribution of embedded gold acupuncture threads, which is unusual.