Chest swelling after puncture and drainage of pleural effusion may be a normal phenomenon, or it may be caused by infection and bleeding, the specific conditions need to go to the hospital for relevant examination and treatment. 1. Normal phenomenon: it is normal for patients to have chest distension after puncture and drainage, if the symptoms are mild, no special treatment is needed, usually the chest distension will be eliminated after a period of recovery, it is recommended that the patients should closely observe their own recovery, and go to the hospital immediately if they feel unwell. 2. Infection: If the patient has serious symptoms and prolonged chest distension, it may be caused by infection during puncture and drainage, and it is recommended that the patient should go to the hospital for examination in time, or can take amoxicillin, cephradine, cefixime and other medicines under the guidance of the doctor for treatment. 3. Bleeding: there is a risk of bleeding after thoracentesis, hemothorax may occur after puncture and drainage of pleural effusion, if there is active bleeding, blood collection in the chest cavity, compression of normal lung tissues, there may be symptoms of chest distension, chest pain, it is recommended to clarify the amount of bleeding in a timely manner, and if necessary, to perform closed chest drainage, and in severe cases, surgery is needed to stop bleeding. It is recommended that patients follow the doctor’s instructions during the recovery process, consult the doctor in time when symptoms occur, and go to the hospital for regular review.