甲状腺手术乳糜漏发生原因及防治  

Postoperative chyle leakage in the thyroid surgery:causes and managements

作　　者：孙团起 吴毅[1,2,3] 

机构地区：[1]复旦大学附属肿瘤医院头颈外科 [2]复旦大学上海医学院肿瘤学系 [3]复旦大学甲状腺肿瘤诊疗研究中心,上海200032

出　　处：《中国实用外科杂志》2012年第5期372-374,共3页Chinese Journal of Practical Surgery

摘　　要：乳糜漏是甲状腺癌颈部淋巴结清扫术后少见但比较严重的并发症。如果处理不当,大量乳糜液丢失,不仅容易引起皮瓣坏死、局部感染,还可导致病人血容量减少,电解质紊乱,甚至可继发颈部血管破裂等严重并发症。大多数病例可以通过持续强负压吸引、加压包扎、饮食控制等保守治疗而治愈。乳糜漏重在预防,术者熟悉颈部解剖、手术操作精细是预防发生乳糜漏的关键,术后及时发现、正确处理多可取得满意疗效。Chyle leakage after neck dissection is an uncommon but potentially lethal complication, which might lead to nutritional, metabolic and immunologic deficiencies. Medical management for chile leakage consists of maintaining closed vacuum suction drainage, pressure dressing, dietary modifications and repeat surgery to stop the lymphatic leak. The best treatment for chyle leakage is prevention. Meticulous surgical technique in the areas of the thoracic duct on the left and the lymphatic ducts on the right will usually prevent the occurrence of the problem. The early exploration would be advised for the good curative effect.

关 键 词：甲状腺肿瘤 颈部淋巴结清扫 乳糜漏 

分 类 号：R6[医药卫生—外科学]