微创心脏手术中复张性肺水肿的防治

Prevention and treatment of reexpansion pulmonary edema in minimally invasive cardiac surgery

复张性肺水肿常发生于气胸减压或胸腔积液快速引流之后,萎陷的肺再次膨胀产生肺水肿。微创心脏手术可以使患者及早的恢复和出院,但是手术中单肺通气、体外循环的并发症如复张性肺水肿常有报道。一旦发生,会给患者的康复造成巨大的困难。本文就国内外的研究作一综述,探讨其发病机制、临床特点、病理生理、防治等。

Reexpansion pulmonary edema often occurs after decompression of pneumothorax or rapid drainage of pleural effu⁃sions.Reinflation of a collapsed lung leads to pulmonary edema.Minimally invasive cardiac surgery has allowed early recovery and dis⁃charge of the patients.However,complication such as reexpansion pulmonary edema induced by single-lung ventilation and cardiopul⁃monary bypass is often reported.Once it happens,the reexpansion pulmonary edema may cause great difficulties for the patient's recov⁃ery.In this review,we summarize the relevant researches at home and abroad to discuss the incidence,clinical features,pathophysiolo⁃gy,prevention and treatment of this complication.