胃癌根治术后腹腔淋巴漏的预防和处理(附13例分析)  

Prevention and treatment of lymphorrhagia in abdominal cavity after the radical operation of gastric cancer (with a report of 13 cases)

作　　者：季巧金[1] 

机构地区：[1]杭州师范大学附属医院普外科,浙江杭州310015

出　　处：《杭州师范学院学报（医学版）》2008年第3期151-152,155,共3页Journal of Hangzhou Teachers College :Medical Edition

摘　　要：目的探讨胃癌根治术后腹腔淋巴漏的发生原因及治疗方法。方法回顾性分析12例胃癌术后淋巴漏的诊治经过。结果术后1周以内每天腹腔引流量≤300 ml者8例,淋巴漏术后一周拔除引流管并缝合皮肤引流口。其余5例应用肠外营养(TPN)和奥曲肽治疗,当引流量减至300ml以下后拔除引流管。所有病例均无明显不良反应,保守治疗治愈。结论胃癌根治术后淋巴漏的发生与肿瘤发展程度关系密切。腹腔引流量<300 ml/d完全可通过腹膜吸收;全胃肠外营养(TPN)配合应用奥曲肽是治疗胃癌术后流量>300 ml/d的淋巴漏的有效方法。Objective To investigate the causes and treatments of lymphorrahagia in abdominal cavity after radical surgical treatment for gastric cancer. Methods 12 cases with lymphorrahagia in abdominal cavity after radical operation of gastric cancer were analyzed retrospectively. Results In 8 cases of lymphorrahagia whose drainage quantity were less than 300 ml per day within postoperative one week, the drainage tubes were removed and the skin was sutured in one week after operation. The other 5 cases were treated with parenteral nutrition and Octeitide hypodermic injection, and the drainage tubes were removed when drainage quantity reduced to less than 300 ml per day. All cases of lymphorragia were not found obvious untoward reactions and were cured of by conservative treatment ＂after operation of gastric cancer. Conclusion Lymphorragia ＂after the radical operation of gastric cancer was highly related to the level of tumor invasion. When the volume of drain was less than 300ml per day, liquid of lymphorragia could be absorbed fully by peritoneum. TPN and Octreitide was an effective method for lymphorrhagia when volume of drain was more than 300 ml per day after the radical resection of gastric cancer.

关 键 词：胃肿瘤 淋巴结清除术 淋巴漏 

分 类 号：R735.2[医药卫生—肿瘤]