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| 題 名 | 再擴張性肺水腫:一個文獻回顧=Re-expansion Pulmonary Edema: A Literature Review |
|---|---|
| 作 者 | 李韋志; 張晉綸; 游舜惟; 黃玉秀; 戴廷育; 陳立峰; 方鈺文; 魏瑄萱; 楊芷寅; 蘇宇軒; 周心玉; 沈德群; | 書刊名 | 台灣急重症醫學雜誌 |
| 卷 期 | 10:3 2025.09[民114.09] |
| 頁 次 | 頁120-125 |
| 分類號 | 415.464 |
| 關鍵詞 | 再擴張性肺水腫; 機轉; 危險因子; 治療; 預防; Re-expansion pulmonary edema; REPE; Mechanism; Risk factors; Treatment; Prevention; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 再擴張性肺水腫是肺臟因為不同原因如氣胸或肋膜腔積液塌陷後,再次擴張時 出現的肺水腫,是一種罕見但可能危及生命的病症。再擴張性肺水腫的致病機轉 仍未完全了解。本研究透過文獻回顧探討再擴張性肺水腫的發生機轉、危險因子、 治療方針和預防。再擴張性肺水腫可能由於肺塌陷導致組織變化再加上通氣與血 液再灌流後導致發炎反應使得微血管通透性增加與破壞所引起。年輕人、肺塌陷 時間過長、再擴張速度太快和心臟相關疾病可能為其危險因子。治療方面,嚴重 的患者以維持呼氣末期正壓為方針,更嚴重的患者可能需要使用葉克膜做為支持 療法。預防再擴張性肺水腫,在處理氣胸或肋膜腔積液時應放慢引流速度,且單 次移除積液應少於 1.5 公升。在治療過程中可以使用肋膜腔測壓儀器和超音波來 監測肋膜腔壓力及評估患者對氣體或液體移除的反應。對於潛在的患者,建議進 行適量運動和戒菸以提升心肺功能來減少再擴張性肺水腫發生的機率。 |
| 英文摘要 | Re-expansion pulmonary edema (REPE) is a rare but potentially life-threatening condition that occurs when the lung, which has collapsed due to various causes such as pneumothorax or pleural effusion, re-expands and develops pulmonary edema. The exact pathophysiological mechanisms of REPE remain incompletely understood. This study reviews the literature to investigate pathogenesis, risk factors, treatment strategies, and prevention of REPE. It is usually hypothesized that REPE results from inflammatory responses triggered by tissue changes due to lung collapse, followed by increased microvascular permeability and damage after re-expansion and reperfusion. Identified risk factors include young age, prolonged lung collapse, rapid re-expansion, and underlying cardiovascular diseases. In terms of treatment, maintaining positive end-expiratory pressure is recommended for severe cases, while extracorporeal membrane oxygenation may be required for critically ill patients as a supportive therapy. To prevent REPE, it is advised to slow the drainage rate when managing pneumothorax or pleural effusion, with a single drainage volume not exceeding 1.5 liters. During the treatment process, pleural pressure monitoring devices and ultrasound can be used to assess pleural pressure and evaluate the patient’s response to gas or fluid removal. For individuals at risk, engaging in moderate exercise and smoking cessation are recommended to improve cardiopulmonary function and reduce the likelihood of REPE occurrence. |
本系統中英文摘要資訊取自各篇刊載內容。