乳糜腹水临床分析并文献复习  

Clinical analysis of chylous ascites：a 3-case report and literature review

作　　者：张树荣[1] 范宗江[1] 李绕梅[1] 刘建昆[1] 刘苗[1] 

机构地区：[1]成都军区昆明总医院消化内科,650032

出　　处：《中国医药》2012年第8期988-989,共2页China Medicine

摘　　要：目的探讨乳糜腹水的临床特征，以提高对该病的认识。方法对我院1995年1月至2010年1月15年间收治的3例乳糜腹水患者的临床资料进行回顾性分析，并结合文献进行复习。结果3例乳糜腹水患者主要表现为腹胀、乏力、纳差、消瘦。腹部超声检查示大量腹水，腹水检查示外观为白色乳糜状或黄白色乳糜状，乳糜试验及苏丹Ⅲ染色均为阳性。3例患者的原发病分别为恶性腹膜间皮瘤、急性肾小球肾炎肾病综合征和乙型肝炎后肝硬化。结论乳糜腹水虽然少见，但病因多种多样，发病机制各异，病情复杂，治疗困难，预后不同。临床医务人员要不断提高对该病的认识，早诊早治，减少误诊。Objective To investigate the clinical features of chylous ascites in order to enhance the awareness of the disease. Methods The clinical data of 3 chylous ascites patients was analyzed retrospectively and relevant literatures were reviewed. Results The major clinical manifestations of the patients were abdominal distension, hypodynamia, anorexia and emaciation. B-abdominal Doppler ultrasound showed massive ascites. The appearance of ascites was white or yellow-white chyle-like shape, and chylous test and Sudan III staining were positive. The primary diseases were malignant peritoneal mesothelioma, nephrotic syndrome and hepatitis B cirrhosis respectively. Conclusions Chylous ascites is a rare disease. Its etiological factors vary and the pathogenesis is different. It is difficult to treat and the prognosis is different. Clinical staff should improve the awareness of early diagnosis and treatment of the disease in order to reduce misdiagnosis.

关 键 词：乳糜腹水 临床特征 恶性腹膜间皮瘤 肾病综合征 肝硬化 

分 类 号：R442.5[医药卫生—诊断学]