纳米碳示踪剂在婴幼儿乳糜腹术中定位淋巴管漏中的初步应用  

Application of nanocarbon in locating lymphatic leakage for infantile chylous ascites

作　　者：高琪 谢卫科 王琪[1] 潘永康 卢朝祥 王璐[1] 魏春玲 李中文 王磊[1] Gao Qi;Xie Weike;Wang Qi;Pan Yongkang;Lu Chaoxiang;Wang Lu;Wei Chunling;Li Zhongwen;Wang Lei(Department of Neonatal Surgery,Affiliated Children's Hospital of Xi'an Jiaotong University,Xi'an 710003,China)

机构地区：[1]西安交通大学附属儿童医院新生儿外科,西安710003

出　　处：《中华小儿外科杂志》2021年第11期985-988,共4页Chinese Journal of Pediatric Surgery

基　　金：陕西省自然科学基础研究计划(2020JQ-931);西安市"科技"+行动计划医学研究项目(2019114613YX001SF042(6));西安交通大学附属儿童医院院级课题(2018C03,2018C01)。

摘　　要：目的探讨纳米碳示踪剂在婴幼儿乳糜腹外科治疗中的应用情况。方法回顾性分析2013年1月1日至2019年11月1日西安交通大学附属儿童医院收治的42例乳糜腹患儿的临床资料。其中,男34例,女8例;年龄为(26.54±10.25)d;孕期检查发现有腹水者6例,出生后逐渐出现腹水者36例。行手术治疗18例,其中使用纳米碳定位导航4例(纳米碳组),采取传统手术包括单纯剖腹探查及使用亚甲蓝者14例(总称为传统手术组);非手术治疗24例(保守治疗组)。结果纳米碳组4例全部找到乳糜腹淋巴管漏,传统手术组仅1例找到漏点。纳米碳组术后特殊奶粉喂养时间为(8±2)周,较保守治疗组及传统手术组中未发现乳糜漏点的患儿术后特殊奶粉喂养时间(16±4)周短,组间比较,差异有统计学意义(P<0.05)。纳米碳组术前、术后禁食时间和总住院时间分别为(14.60±3.68)d、(5.40±4.56)d和(31.63±9.36)d,均短于传统手术组(19.38±3.60)d、(7.86±2.51)d和(39.82±2.59)d,组间比较,差异均有统计学意义(P均<0.05)。结论纳米碳利用淋巴管自身结构特性,可成功导航定位出乳糜腹淋巴管漏的位置便于进行精准手术治疗,明显缩短了乳糜腹病程和特殊奶粉使用时间。Objective To explore the surgical application of nanocarbon for chylous ascites(CA).Methods From January 1st,2013 to November 1st,2019,42 children were definitely diagnosed as CA.Clinical characteristics,treatments and short-term outcomes were assessed retrospectively.There were 34 males and 8 females aged(26.54±10.25)d.CA was detected during pregnancy examination(n=6)while the remainder gradually appeared after birth(n=36).Among 18 surgical cases,4 cases used nanocarbon.Twenty-four cases received conservative measures.Results In nanocarbon group,all four cases were confirmed while only one case was detected in conventional surgical group.Time of special milk powder post-operation was shorter in nanocarbon group than that in non-operation group[(8±2)vs.(16±4)weeks].And the differences were statistically significant(P<0.05).Preoperative fasting time,postoperative fasting time and total hospital stay of nanocarbon group were shorter than those of traditional surgical group[(14.60±3.68)vs.(19.38±3.60)days,(5.40±4.56)vs.(7.86±2.51)days and(31.63±9.36)vs.(39.82±2.59)days](all P<0.05).Conclusions Nanocarbon can successfully locate the leakage site based upon structural characteristics of lymphatic vessels.With the exploration of CA,the results will be significantly improved.Therefore reasonable decisions should be made for gradual curing.

关 键 词：乳糜腹 纳米碳 精准外科 

分 类 号：R726.5[医药卫生—儿科]