支气管肺癌根治术后并发乳糜胸的诊治分析  

Clinical management on chylothorax of post-operation of bronchial carcinoma

作　　者：李峰[1] 庞中好 陈圣杰[1] 俞力超[1] 蒋志华[1] 李刚[1] LI Feng;PANG Zhong-hao;CHEN Shengjie;YU Li chao;JIANG Zhihua;LI Gang(Department of Cardiothoraeie Surgery,Affiliate Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院胸心外科,江苏镇江212001

出　　处：《中国肿瘤外科杂志》2018年第2期106-108,共3页Chinese Journal of Surgical Oncology

基　　金：江苏省中医药管理局项目(YB2017101);江苏大学附属医院人才启动基金项目(2018)

摘　　要：目的探讨支气管肺癌根治性切除术后发生乳糜胸并发症的临床诊治方法。方法收集2015年1月至2018年2月江苏大学附属医院胸心外科行支气管肺癌根治性切除术后发生乳糜胸并发症11例患者的临床资料。其中4例24 h胸腔引流量250~400 ml,予禁油腻食物并予以高蛋白支持;6例24 h胸腔引流量400~700 ml,予生长抑素治疗并间隙性夹闭胸腔闭式引流管;1例24 h胸腔引流量700~1 200 ml,予胸腔灌注金葡素注射液。结果 11例经保守治疗全部治愈。所有患者拔管后无胸闷、气促、心率加快症状,3 d后复查胸片未见明显积液。结论支气管肺癌根治性切除术中行系统淋巴结清扫易损伤胸导管分支及交通淋巴管,引起乳糜胸并发症,采取个体化精准的保守治疗,均可治愈。Objective To explore the clinical diagnostic and treatment of chylothorax complications after radical resection of bronchogenic carcinoma. Methods Clinical data of 11 patients with chylothorax complications were analyzed retrospectively after radical resection of bronchogenic lung cancer in the Affiliated Hospital of Jiangsu University from January 2015 to February 2018. Among them,4 patients received 250-400 ml of chest drainage for 24 h,and they received high-protein support and no greasy food. Six patients with 400-700 ml received somatostatin and closed thoracic closed drainage tube. One patient received 24 h chest drainage（ 700-1 200 ml） was given intrathoracic perfusion of staphylococcin injection. Results All of the 11 cases were cured by conservative treatment. All patients had recovery of chest congestion,shortness of breath,rapid heart rate after extubation,and there was no significant effusion after 3 days of chest X-ray examination. Conclusions Radical resection of bronchial lung cancer in the system is easy to clean the lymphatic branches of the thoracic duct and traffic lymphatic vessels caused by chylothorax complications. It could be applied by individualized treatment,and cured by conservative treatment.

关 键 词：支气管肺癌 乳糜胸 临床诊治 手术并发症 

分 类 号：R734.2[医药卫生—肿瘤]