肝硬化所致乳糜性胸水的临床分析——附4例报告  

Clinical Analysis of Chylothorax Complicating Hepatic Cirrhosis

作　　者：李晓燕[1] 朱森林[1] 陈旻湖[1] 胡品津[1] 

机构地区：[1]中山大学附属第一医院消化科,广州510080

出　　处：《临床消化病杂志》2011年第4期195-197,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的探讨肝硬化所致乳糜性胸水的临床特点及诊断方法。方法回顾分析我院2003年1月至2009年12月诊断4例肝硬化所致乳糜胸水的临床病例资料,分析其临床特点、诊断和治疗效果。结果 4例患者均携带有乙型肝炎病毒。胸水检查:外观为黄白色或白色乳糜状,实验室检查确诊为真性乳糜胸水(乳糜试验及苏丹Ⅲ染色均阳性)。在综合治疗的基础上,结合胸腔粘连术或经颈静脉肝内门体分流术(TIPS)对肝硬化所致乳糜性胸水的近期治疗效果良好。结论肝硬化并乳糜胸水在临床上比较少见。治疗上可在常规护肝、支持治疗的同时,根据患者病情选择TIPS、胸腔粘连术或胸导管结扎术等有一定疗效。Objective To investigate the clinical features,diagnosis and therapy of chylothorax complicating hepatic cirrhosis.Methods All 4 cases of chylothorax complicating hepatic cirrhosis from 7 years of consecutive clinical data in our hospital were enrolled in this study.The clinical features,diagnosis and therapeutic approach for chylothorax in hepatic cirrhosis were analyzed retrospectively.Result All the 4 cases of cirrhosis of liver were HBV carriers.Based on combination treatment,the recent therapeutic effect of pleutodesis or transjugular intrahepatic portosystemic shunt（TIPS） creation on chylothrax complicating hepatic cirrhosis were inspiring.Conclusion Chylothorax complicating cirrhosis of liver was rare clinically.Based on routine liver protection and supportive therapy,TIPS,pleurodesis or thoracic duct ligation may be effective for the treatment chylothorax complicating hepatic cirrhosis.

关 键 词：肝硬化 乳糜性胸水 诊断 治疗 

分 类 号：R575.2[医药卫生—消化系统]