肺癌术后乳糜胸的治疗对策  

Treatment Strategy for Chylothorax after Resection for Lung Cancer

作　　者：王长利[1] 姜宏景[1] 刘朝永[2] 赵镇清[1] 李晓琳[1] 齐大亮[1] 宫立群[1] 

机构地区：[1]天津医科大学附属肿瘤医院胸科,天津市300060 [2]河北省唐山市开滦医院胸外科

出　　处：《中国肿瘤临床》2004年第15期885-887,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:回顾肺癌肺切除和淋巴结清扫术后并发乳糜胸的病例,分析其治疗对策。方法:1997年7月～2003年12月,共1546例肺癌患者行肺切除术(至少是肺叶切除术)并行系统的淋巴结清扫。其中16例术后并发乳糜胸,均以保守治疗(闭式引流,胸腔内注药,全胃肠外营养或低脂饮食)。结果:全部16例均经保守治疗治愈。该组患者在乳糜胸确诊后经6～21天治疗,平均于9.8天后可进正常饮食。胸引流量最多2100ml/天。结论:由于解剖及生理的原因,以及各种营养支持治疗的进展使其保守治疗的成功率不断提高,我们认为该类术后乳糜胸如果处理得当,完全可以保守治疗治愈。Objective: To review the experience with iatrogenic chylothorax after pulmonary resections for lung cancer and evaluate our treatment strategy. Methods: From July 1997 through December 2003, a total of 1546 patients underwent pulmonary resection(at least lobectomy) and systematic mediastinal lymph node dissection for lung cancer in our division. 16 patients had postoperative chylothorax complication. All of these patients conservatively with complete oral intake cessation and total parenteral nutrition were treated in this study. Results: All patients had the condition cured with conservative treatment. These patients showed a normal diet at a median of 9.8 days after chylothorax diagnosis (range 6-21days). Conclusion: If the right treatment strategy was chosen, most cases of chylothorax after pulmonary resection with systematic mediastinal lymph node dissection can be cured with a conservative strategy.

关 键 词：肺癌 乳糜胸 术后 治疗 

分 类 号：R734.2[医药卫生—肿瘤]