医用生物胶黏合封堵乳糜瘘12例(英文)  

Medical biological adhesive treatment of chylous fistula in 12 cases

作　　者：吴晶[1] 冯元勇[1] 金晓明[1] 王增峰[1] 苗海平[1] 闫萍[1] 尚伟[1] 

机构地区：[1]青岛大学医学院附属医院口腔颌面外科,山东省青岛市266003

出　　处：《中国组织工程研究与临床康复》2011年第21期3987-3990,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:针对口腔颌面部肿瘤扩大切除术同时行颈部淋巴结清扫术中并发乳糜瘘的问题。很多专家学者有不同的处理方式,单纯的手术结扎、强负压引流或者是单纯的肌肉组织填塞或者以上方法的组合,在预后及治疗效果上存在或多或少的缺陷。目的:评价颈部淋巴清扫术中采用医用生物胶黏合周围自体肌肉组织封堵胸导管瘘口以预防术后乳糜瘘的疗效。方法:12例口腔癌患者在颈淋巴清扫术中发现并确诊为乳糜瘘后,立即行瘘口缝扎并应用医用生物胶黏合周围自体肌肉组织封堵瘘口。结果与结论:10例患者术中经此方法治疗后术后未出现乳糜瘘及其他严重并发症;2例患者经此法治疗无效后,二次手术探查行瘘口缝扎及应用医用生物胶黏合封堵治疗后有效。术后随访所有12例患者3个月均未发现有乳糜瘘复发,亦未出现局部刺激反应及变态反应。结果表明术中医用生物胶黏合封堵胸导管瘘口是预防颈淋巴结清扫术后乳糜瘘理想、安全的治疗方法。BACKGROUND：As for the treatment of chylous fistula concurrent in oral-maxillofacial tumor resection simultaneously undergoing neck lymph node dissection,many different approaches have been put forward.A simple surgical ligation,strong negative pressure drainage,filling the muscle tissue alone or a combination of the above methods are all unsatisfactory regarding the prognosis and curative effect.OBJECTIVE：To evaluate the validity of medical biological adhesive cohering peripheral autologous muscle tissues to block thoracic duct fistula in order to prevent chylous fistula following neck lymph node dissection.METHODS：All of the 12 patients were detected and diagnosed as chylous fistula in neck lymph node dissection surgery,the wounds were immediately sutured and treated with medical biological adhesive cohering peripheral autologous muscle tissues to block thoracic duct fistula.RESULTS AND CONCLUTION：Of all the 12 patients,10 recovered without chylous fistula or severe complications,and reoperations were adopted to cure the failed 2 cases.All patients were visited 3 months postoperatively,no recurrence of chylous fistula,local stimulus response or allergy was found.It is suggested medical adhesive to block thoracic duct fistula may be an effective and safe way for prevent chylous fistula following neck lymph node dissection.

关 键 词：淋巴转移 颈淋巴清扫术 乳糜瘘 医用生物胶 预防 

分 类 号：R318[医药卫生—生物医学工程]