肺毛細血管透過性の亢進を呈したRe-expansion Pulmonary Edemaの一例

A case of re-expansion pulmonary edema with increased pulmonary capillary permeability

　自然気胸に対する脱気療法後に，患側肺に一側性〜限局性肺水腫が発生することが，稀ではあるが報告されている（re-expansion pulmonary edema，以後REPEと略する）。欧米では1959年のCarlsonらの報告^1）以来，本邦では1972年の沢村らの報告^2）以来，REPEは漸増傾向にはあるが，いまだその報告例は少なく，その成因についても定説がない。今回我々は，肺毛細血管の透過性の亢進が重要な—因となっていると考之られるREPE症例を経験したので，若干の文献的考察を加えて報告する。

A case of re-expansion pulmonary edema with increased pulmonary capillary permeability was re-ported. A male aged 21, who had suffered from complete spontaneous pneumothorax for the past 6 days, was admitted to our hospital because of in-creasing dyspnca after pleural aspiration in minus 15 cm H₂O through a chest tube. A chest X ray showed severe unilateral pulmonary edema.

The colloid osmotic pressure of the pulmonary edema fluid was 12.1 mmHg and a serum colloid osmotic pressure, 17.6 mmHg. The edema fluid to serum colloid pressure ratio was 0.68, which showed that this edema is typical of noncardiogenic pulmo-nary edema secondary to increased permeability.