Re-expansion Pulmonary Edema following Thoracoscopic Drainage of a Massive Pleural Effusion: A Case Report and Literature Review

胸腔鏡施行大量肋膜積水引流併發術後擴張性肺水腫之病例報告與文獻回顧

陳明山(Ming-Shan Chen) ； 梅匯潮(Wui-Chiu Mui) ； 吳國安(Kwok-On Ng)

《童綜合醫學雜誌》 11卷1期 (2017/06) Pp. 26-30

摘要

Re-expansion pulmonary edema (RPE) is a rare complication of treatment for pleural effusion and pneumothorax. It typically manifests as edema within the lung that has recently been re-expanded. The condition generally occurs unexpectedly and dramatically, either immediately or within 24 h. Its clinical manifestations are varied, ranging from chest X-ray findings alone in asymptomatic patients to severe cardiorespiratory insufficiency. Here we present a case on unilateral RPE after draining a left-sided massive pleural effusion. In addition, several recent research articles on the pathophysiology and treatment of RPE are discussed.

關鍵字

re-expansion pulmonary edema ； pleural effusion ； pneumothorax ； thoracoscopic surgery ； thoracentesis

並列摘要

在治療肋膜腔積水與氣胸時，再擴張型肺水腫是少見的併發症。典型上當肺再次擴張時反而引起肺積水。這情況的發生常常無法預期而且是戲劇性的。在24 小時內臨床上的表現是輕重程度不同，從只有X 光上的表徵而沒有症狀，到嚴重的心肺衰竭。再此我們報告一例病人，在做完左側大量的肋膜腔積水引流後發生再擴張型肺水腫，並對其形成原因與治療做相關文獻回顧討論。

並列關鍵字

再擴張型肺水腫 ； 肋膜腔積水 ； 氣胸 ； 胸腔鏡手術 ； 胸腔引流