乳糜性腹水的临床分析  

Clinical analysis of lacteal ascites

作　　者：李再波[1] 

机构地区：[1]枣庄市立医院感染肝病科,山东枣庄277102

出　　处：《医药论坛杂志》2011年第8期20-22,共3页Journal of Medical Forum

摘　　要：目的探讨乳糜腹水的临床特点和治疗方法。方法分析国内20余年有关文献复习,分析乳糜腹水的病因、临床表现、诊断和治疗方法。结果国内报道乳糜腹水258例,其中男165例,女93例,年龄32d^92岁;病因以恶性肿瘤(23.40%)、结核(12.99%)、肝硬化(14.29%)为主;临床表现在原发病的症状基础上,患者均有腹胀、腹泻、消瘦、营养不良、腹水、低蛋白血症及低热、腹痛,合并有乳糜胸水的占35.06%。结论乳糜性腹水临床少见。放射性核素淋巴显像、X线淋巴管造影、口服13C长链脂肪酸(13C-LCT)定位检查有助于病因的诊断。治疗首先针对原发病,可辅以饮食调理、腹腔穿刺、中药、手术。患者预后主要取决于原发病性质,总体病死率很高。Objective To explore the clinical character and remedial method of lacteal ascites.Methods To analyze correlative domestic reference resources within more than 20 years,and analyze the pathogeny,clinical representation and remedial method of lacteal ascites.Results Within the 258 cases of lacteal ascites in domestic reports,165 sufferers are male,and 93 sufferers female,whose age range from 32 days to 92 years old;The main pathogeneses are malignancy（23.40 percent）,tuberculosis（12.99 percent）,hepatocirrhosis（14.29 percent）.The clinical representation is the primary affection symptoms as well as abdominal distention,diarrhea,physically thin,malnutrition,ascites,hypoproteinemia,low fever and bellyache,with some cases（35.06 percent） having lacteal hydrothorax.Conclusions The cases of lacteal ascites are not common.Radioactive nuclides lymphatic raster display,X-ray lymphatic visualization,take 13c long chain fatty acid（13c-LCD）.Orientation check-up is helpful to the diagnosis of pathogeny.The first concern of remedy is to cure the primary affection symptoms,with the assistance of dietetic adjustment celiac centesis and the application of Chinese traditional medicine and operation.The result of the operation mainly lies on character of the primary affection symptoms,with a considerably high death rate.

关 键 词：乳糜腹水 诊断 治疗 

分 类 号：R442.5[医药卫生—诊断学]