开胸术后复张性肺水肿的探讨

Analysis for reexpansion pulmonary edema following thoracotomy

目的 :探讨开胸手术中单侧肺萎陷、术后肺复张导致急性肺水肿的发病机理、诊断治疗及预防。方法 :对5例开胸术后复张性肺水肿患者进行总结 ,3例为胸腔镜辅助下胸膜固定术后 ,2例为食管癌根治术后。结果 :常规单侧肺萎陷的开胸手术均可能发生轻重不一的复张性肺水肿。结论 :可通过术中定期 (以间隔 30min为宜 )

Objective:To investigate the principle of diagnosis,treatment and prevention of reexpansion pulmonary edema(RPE)following thoracotomy.The lung had been shrunk in these operations.Methods:Five patients got RPE,three of those were performed the pleurodesis with thoracoscope,and two patients were performed esophagectomy for treatment of esophageal carcinoma.Results:RPE related to the pulmonary shrink,for the shrinkable pulmonary tissues was hypoxemic and increased the permeability of the pulmonary capillary,hence caused RPE.The pulmonary shirnk caused a greater or lesser degree of RPE in conventional thoracotomy.Conclusion:To reduce the incidence of RPE,it is important to expand the lung intermittently and slowly during operation.