1.临床资料:我院于1998年2月6日收治一男性病人28岁,以进行性呼吸困难一月余之主诉入院,体检:一般情况差,强迫坐位,呼吸短促,持续吸氧。气管右移,胸廓欠对称,左侧饱满,双侧呼吸动度减弱,左呻呼吸音消失,右肺呼吸音减弱。双肺未闻及干湿鸣。腹膨隆,腹水征阳性。胸片及胸部CT示:左胸腔大量积液,胸膜增厚。胸部B超示:左侧腋前线、腋中线第7至9肋间可探及115mm液性暗区,内可见大量增强光带分隔,呈多房样,胸膜增厚18mm。病理报告:横纹肌肉瘤。入院诊断:左侧胸壁横纹肌肉瘤侵犯胸膜,左侧胸腔积液,腹水形成。2.方法:穿刺前用微型SPO_2仪持续监测,病人血清氧饱和度值显示为89%。然后,在局麻下,以18号硬膜外阻滞穿刺针于左肩胛线内1cm第8第9肋间隙穿刺,经调整不同方向抽出929ml暗褐色液体,之后经此穿刺针下入颈内静脉导引钢丝10cm,退出硬膜外阻滞穿刺针,用颈内静脉穿刺扩 1. Clinical data: On February 6, 1998, our hospital admitted a male patient 28 years old to perform sexually breathing difficulties more than a month after the main complaint was admitted to the hospital. The physical examination was generally poor, forced sitting, shortness of breath, and continued oxygenation. The trachea shifts to the right, the thoracic symmetry is less symmetrical, and the left side is full. The bilateral respiratory motions are weakened, the left iliac breath sounds disappear, and the right lung breath sounds are weakened. Lungs did not smell dry and wet. Abdominal bulging, positive ascites. Chest and chest CT showed a large effusion in the left thoracic cavity and thickened pleura. Chest B-show: the left anterior tibial line, the 7th to 9th intercostal space in the midaxillary line can be explored and 115mm liquid dark area, there are a large number of enhanced light bands separated, showing a multi-room, pleural thickening 18mm. Pathology report: Rhabdomyosarcoma. Admission diagnosis: The left chest wall rhabdomyosarcoma invaded the pleura, left pleural effusion, ascites formation. 2. Method: Continuous monitoring with micro SPO_2 instrument before puncture, the serum oxygen saturation value of the patient was 89%. Then, under local anesthesia, a 18-gauge epidural anesthesia puncture needle was used to puncture the first 9th intercostal space of 1cm in the left scapular line, and 929ml of dark brown liquid was drawn out in different directions. Then the puncture needle was inserted into the neck. Vein guide wire 10 cm, exit epidural aspiration needle, use internal jugular vein puncture