Sherman Scott C
Department of Emergency Medicine, Cook County Hospital, Chicago, Illinois 60612, USA.
J Emerg Med. 2003 Jan;24(1):23-7. doi: 10.1016/s0736-4679(02)00663-7.
This case report illustrates the presentation and course of reexpansion pulmonary edema (REPE) in a young man with spontaneous pneumothorax. REPE is considered relatively uncommon by most accounts, but in certain clinical circumstances the incidence is much higher. Although supportive therapy is the rule, the condition is far from benign and mortality estimates are as high as 20%. Risk factors, including young age, a large pneumothorax and longer duration of collapse, may help predict which patient will encounter this complication. In patients with these risk factors, the thoracostomy tube should be initially left off suction in an effort to prevent REPE primarily. When REPE is encountered, therapy is supportive.
本病例报告阐述了一名患有自发性气胸的年轻男性再膨胀性肺水肿(REPE)的临床表现及病程。多数报道认为REPE相对不常见,但在某些临床情况下其发生率要高得多。尽管通常采用支持性治疗,但该病症绝非良性,死亡率估计高达20%。包括年轻、气胸量大和肺萎陷持续时间长等危险因素,可能有助于预测哪些患者会出现这种并发症。对于有这些危险因素的患者,胸腔造瘘管最初应停止吸引,主要目的是预防REPE。当发生REPE时,治疗以支持性为主。