颈段胸导管的应用解剖与颈廓清术并发乳糜漏的防治  

Applied anatomy of thoracic duct at cervical part and treatment for chylous fistula after radical neck dissection

作　　者：马丹[1] 刘敏[2] 李红[3] 杨桦[1] 

机构地区：[1]第三军医大学新桥医院普通外科,重庆400037 [2]第三军医大学新桥医院神经外科,重庆400037 [3]第三军医大学新桥医院耳鼻喉科,重庆400037

出　　处：《局解手术学杂志》2010年第6期471-472,共2页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨颈段胸导管的临床应用解剖,以及颈廓清术并发乳糜漏的预防与治疗方法。方法 25例颈廓清术后并发乳糜漏患者中,18例行负压吸引、局部加压包扎等保守治疗;7例再次行结扎胸导管漏口、肩胛舌骨肌填塞等手术治疗。结果 18例行保守治疗的患者中16例治愈,2例经再次手术治愈;7例再次行手术治疗的患者全部治愈,所有患者随访至今未见异常。结论预防颈廓清术并发乳糜漏的关键在于熟悉颈段胸导管的应用解剖,根据乳糜漏的具体情况采取相应的治疗方法可取得满意疗效。Objective To summarize applied anatomy of the thoracic duct at cervical part and experiences in treating chylous fistula after radical neck dissection. Methods Of all the 25 cases df chylous fistula after radical neck dissection, 18 cases were treated with conservative method （vacuum aspiration, local pressure dressing） and 7 cases were treated with operation （ligation of chylous fistula and obstruction with omohyoid）. Results In the 18 cases treated with conservative method, 16 cases healed once and 2 cases cured after another operation.＂ All the seven cases treated with operation cured. No recurrence occurred during the follow-up. Conclusion The key point to avoid chylous fistula in radical neck dissection is to familiarize with applied anatomy of the thoracic duct at cervical part and to choose the appropriate treatment methods according to the state of chylous fistula

关 键 词：胸导管 颈廓清术 乳糜漏 治疗 

分 类 号：R322.26[医药卫生—人体解剖和组织胚胎学] R653[医药卫生—基础医学]