甲状腺手术后颈部乳糜漏的预防及处理  

Management of chyle leakage after thyroidectomy

作　　者：孙团起 SUN Tuan-qi(Department of Head and Neck Surgery, Fttdan University Shanghai Cancer Center （FUSCC;Department of Oncology, Shanghai Medical College, Fudan Universit;Fudan University Thyroid Cancer Center, Shanghai 200032, China)

机构地区：[1]复旦大学附属肿瘤医院头颈外科复旦大学上海医学院肿瘤学系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》2018年第6期628-630,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相对少见但处理困难的并发症。常规的保守治疗包括仅含中链甘油三酯的低脂饮食、持续低负压吸引、局部注射硬化剂、生长抑素的使用和局部加压包扎治疗等。大多数乳糜漏经综合非手术疗法均可痊愈,仅有少数病人需要外科手术探查结扎瘘管。乳糜漏重在预防,熟悉解剖和精细操作是减少乳糜漏的关键。Chyle leakage is an uncommon but serious complication after thyroidectomy and/or cervical lymph node dissection. The most appropriate options should include both conservative and surgical treatment strategies. Non-operative approaches consist of medium-chain fatty acid diet, drainage of the leakage, injection of a sclerosing agent, somatostatin analogs such as octreotide and negative wound pressure therapy. The most of chyle leakages are effectively controlled with conservative management. Surgical intervention should only be considered if the patient has failed all conservative measures.

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]