腹膜后淋巴管结扎加静脉分流治疗乳糜外瘘六例  

Treating external chylous fistula with retroperitoneal lymphangiectomy plus lymph-vein shunting

作　　者：孙迎宪 沈文彬[1] 耿万德[1] 吴国富[1] 孙宇光[1] 夏松[1] 

机构地区：[1]北京市公安医院外科,100006

出　　处：《中华外科杂志》2002年第7期508-510,共3页Chinese Journal of Surgery

基　　金：首都医学发展科研基金重点学科项目 (ZD199818)

摘　　要：目的　探讨乳糜返流导致乳糜外瘘的诊断与治疗。　方法　 6例患者均采用直接淋巴管造影、核素淋巴显像诊断 ,其中 2例直接淋巴管造影后CT辅助诊断。 5例采用腹膜后淋巴管结扎加静脉分流治疗 ,1例仅腹膜后淋巴管结扎。　结果　本组 6例患者 ,术后随访 6个月～ 6年 ,5例乳白色小疱消失 ,乳糜外瘘愈合 ;1例乳糜外瘘未愈 ,阴囊仍有乳糜液流出。　结论　腹膜后淋巴管结扎加分流术治疗下肢及外生殖器乳糜外瘘取得较好效果 ,但有不能完全阻断返流的病例 ,故对此术式需进一步改进。Objective To discuss the diagnosis and therapy of chylous reflux and external chylous fistula. Methods All of 6 patients were diagnosed with direct lymphagiography, lymphscintigraphy. Among them, 2 patients received CT after direct lymphagiography. Retroperitoneal lymphangiectomy plus lymph vein shunting was performed in 5 patients, and retroperitoneal lymphangiectomy in 1 patient. Results The 6 patients were followed up from 6 months to 6 years. In 5 patients, chylous cysts disappeared and chylous fistula closed, and in 1 patient, chylous fistula didn′t cicatrize, and chyle still leak out from the scrotum.Conclusions Retroperitoneal lymphangiectomy plus lymph vein shunting has curative effect on chylous external fistula of the lower extremity and genitalia, but it has the chance to not obstruct all paths of chylous reflex.

关 键 词：腹膜后淋巴管结扎 静脉分流 治疗 乳糜外瘘 

分 类 号：R656[医药卫生—外科学]