颈淋巴清扫术后乳糜漏2例报告  

Chylous Fistula Complicated with Neck Dissection:report of 2 cases

作　　者：杨军成[1] 刘广毅 何福江[1] 

机构地区：[1]四川省广元市第一人民医院口腔科,四川广元628017

出　　处：《口腔颌面外科杂志》2010年第1期46-48,共3页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨颈淋巴结清扫术后乳糜漏的治疗方法。方法:回顾性分析口腔颌面部恶性肿瘤颈淋巴结清扫术后2例乳糜漏患者的临床资料。对2例患者先进行保守治疗,禁食,局部加压包扎,持续强负压吸引(压力一般在-0.02～-0.06 MPa之间)。其中1例强负压吸引时最大引流量达2 100 mL/d,局部加压包扎13 d无效后,再次手术结扎左胸导管。结果:1例乳糜漏经强负压吸引、加压包扎等处理1 d后治愈。另1例经加压包扎13 d无效,经胸导管结扎后2 d治愈。结论:及早发现颈淋巴结清扫术后乳糜漏,强负压吸引,适当加压包扎是治疗乳糜漏较为安全有效的方法,对于引流量超过500 mL/d者,应尽早打开缝扎淋巴导管。Objective：To brief on the treatment results of 2 chylous fistulas after radical neck dissection.Methods：Retrospective analysis of 2 cases.Conservative measures were the first choice：an absolute diet,partial pressure dressing,uninterrupted powerful vacuum aspiration（pressure generally between-0.02～-0.06 MPa）.Apart from those measures,one case were underwent another operation to ligate left alimentary duct.Results：One chylous fistula cured at the next day of partial pressure dressing and uninterrupted powerful vacuun aspiration,and the other case cured 2 days after lymphatic duct transfixation.Conclusion：Chylous fistula should be discovered as early as possible,and the safety and effective therapeutic method are continuously powerfully vacuum aspiration and partly pressure dressing,if the flow rate exceed 500 mL/d,lymphatic duct transfixation is necessary.

关 键 词：颈淋巴结清扫术 乳糜漏 并发症 

分 类 号：R739.8[医药卫生—肿瘤]