腹部手术后9例乳糜漏的治疗  

Treatment of Chylous Leakage Due to Abdomen Operation:a Report of 9 Cases

作　　者：施其龙[1] 朱革非[1] 

机构地区：[1]安徽省宿州市立医院综合外科,234000

出　　处：《中华全科医学》2010年第8期983-984,共2页Chinese Journal of General Practice

摘　　要：目的探讨腹腔手术后乳糜漏发生、发展的规律及防治方法。方法对于腹部外科手术病例,术后密切观察引流管引流量、性状的变化,对有异常情况的常规行引流液乳糜定性及微生物涂片和培养,对乳糜定性阳性者,观察乳糜漏的发生、发展规律,明确引流管拔除的时机。结果 8例分别于乳糜漏出现后7d内(2例)、7～14d(5例)、14d后(1例)治愈,另一例为胃癌根治术后患者,乳糜漏未彻底治愈,带管出院,化疗1周期后,腹腔引流明显减少,B超示无明显腹腔积液。当乳糜漏的引流管引流量几乎为零,B超检查提示腹腔无积液,患者一般情况良好,无感染表现,即可拔管。结论腹腔手术后发生乳糜漏,若及时发现,采用禁食、全胃肠外营养(TPN)、充分引流等非手术治疗,乳糜漏可痊愈。Objective To investigate the occurrence,development and management of chylous leakage due to operation on abdomen.Methods Nine cases undergoing abdomen operation were selected to observe the volume and characters of drainage liquid.The abnormal drainage liquids was differentiated,smeared and cultured.In patients with a positive result of chyle examination,the development of chylous leakage was observed,and the optimal time to remove the drainage tube was determined.Results 8 cases of chylous leakage were cured,in which 2 cases in 7 days,5 cases between 7 and 14 days,and 1 case after 14 days.The other one who received a gastric carcinoma operation was not completely cured and discharged with drainage tube;after 1 course of chemotherapy,the drainage liquid was significantly reduced,no hydrops in peritoneal cavity was found by B ultrasound,and the patient were in good condition without signs and symptoms of infections.Conclusion Chylous leakage after abdomen operation is able to be cured by immediate diagnosis,fasting,TPN and drainage.

关 键 词：腹腔手术 乳糜漏 

分 类 号：R656[医药卫生—外科学] R551.2[医药卫生—临床医学]