Haga Takahiro, Kurihara Masatoshi, Kataoka Hideyuki
Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-ku, Tokyo, 156-0095, Japan,
Surg Today. 2014 Oct;44(10):1823-7. doi: 10.1007/s00595-013-0726-y. Epub 2013 Sep 25.
Re-expansion pulmonary edema is an uncommon condition that occurs when a collapsed lung is expanded. The aim of the present study was to investigate the incidence and risk factors associated with re-expansion pulmonary edema which may occur as a complication when carrying out treatment for spontaneous pneumothorax.
A total of 462 patients with spontaneous pneumothorax treated with chest tube drainage in inpatient settings at the Nissan Tamagawa Hospital during the 6-year period between January 2007 and December 2012 were retrospectively evaluated. The data were analyzed to identify any clinical differences between the patients with and without re-expansion pulmonary edema.
Re-expansion pulmonary edema occurred on 30 (6.5 %) of the 462 patients. The duration of lung collapse in the patients with re-expansion pulmonary edema was longer than that observed in the patients without re-expansion pulmonary edema. (7.7 ± 9.1 and 2.4 ± 4.6 days). This difference was statistically significant (P < 0.0001). The extent of lung collapse in the patients with re-expansion pulmonary edema was more severe than that observed in the patients without re-expansion pulmonary edema. This difference was also statistically significant (P = 0.004).
The results suggest that treating spontaneous pneumothorax using chest tube drainage requires careful consideration in view of the relatively high incidence of re-expansion pulmonary edema, especially in cases associated with long periods of lung collapse or large spontaneous pneumothoraxes.
复张性肺水肿是一种在萎陷肺复张时发生的罕见病症。本研究的目的是调查复张性肺水肿的发生率及其相关危险因素，复张性肺水肿可能作为自发性气胸治疗过程中的一种并发症出现。
回顾性评估2007年1月至2012年12月这6年间在日产玉川医院住院接受胸腔闭式引流治疗的462例自发性气胸患者。对数据进行分析，以确定发生和未发生复张性肺水肿的患者之间的任何临床差异。
462例患者中有30例（6.5%）发生了复张性肺水肿。发生复张性肺水肿的患者肺萎陷持续时间长于未发生复张性肺水肿的患者。（分别为7.7±9.1天和2.4±4.6天）。这种差异具有统计学意义（P<0.0001）。发生复张性肺水肿的患者肺萎陷程度比未发生复张性肺水肿的患者更严重。这种差异也具有统计学意义（P=0.004）。
结果表明，鉴于复张性肺水肿的发生率相对较高，尤其是在与长时间肺萎陷或大量自发性气胸相关的病例中，使用胸腔闭式引流治疗自发性气胸需要谨慎考虑。
