经腹股沟淋巴结穿刺淋巴管造影诊断和治疗乳糜漏6例  

Application of inguinal lymph node puncture lymphangiography in the diagnosis and treatment of chyle leakage:clinical results in 6 patients

作　　者：白旭 包晗 黄媛丹 洪铎[1] 苏洪英[1] 韩向军[1] BAI Xu;BAO Han;HUANG Yuandan;HONG Duo;SU Hongying;HAN Xiangjun(Department of Interventional Therapy,First Affiliated Hospital of China Medical University,Shenyang,Liaoning Province 110001,China)

机构地区：[1]中国医科大学附属第一医院介入治疗科,辽宁沈阳110001

出　　处：《介入放射学杂志》2023年第2期158-161,共4页Journal of Interventional Radiology

摘　　要：目的 评价经腹股沟淋巴结穿刺淋巴管造影诊断和治疗乳糜漏的安全性和有效性。方法回顾性分析6例保守治疗失败的乳糜漏患者资料。患者在超声和DSA导引下,接受经双侧腹股沟淋巴结穿刺、碘化油行淋巴管造影术。观察手术技术成功率、检测淋巴管漏点的能效、术后淋巴液引流量变化、碘化油封堵作用对乳糜漏治愈时间、手术并发症。结果 6例患者均完成经腹股沟淋巴结穿刺淋巴管造影术,技术成功率为100%。手术时间为(2.7±0.5)h。5例患者发现淋巴管漏点,有效率为5/6。术后24 h淋巴液引流量由术前(810.0±708.4)mL减少至(355.0±388.3)mL,(12.4±7.5)d后乳糜漏消失。1例患者出现碘化油肺栓塞,经对症处理后相关症状消失。结论 经腹股沟淋巴结穿刺淋巴管造影诊断乳糜漏具有微创、相对安全、较为有效的特点,同时兼具治疗乳糜漏作用。ObjectiveTo evaluate the safety and effectiveness of inguinal lymph node puncture lymphangiography in the diagnosis and treatment of chyle leakage.MethodsThe clinical data of 6 patients with chyle leakage,who failed to response to conservative treatment,were retrospectively analyzed.Under the guidance of ultrasound and DSA,the puncture of bilateral inguinal lymph nodes was performed,which was followed by lymphangiography with injection of lipiodol.The technical success rate,the detection of lymphatic leakage point,the postoperative change of lymphatic fluid amount,the sealing effect of lipiodol,the time of chyle leakage cure,and surgical complications were evaluated.ResultsSuccessful inguinal lymph node puncture lymphangiography was accomplished in all the 6 patients,with a technical success rate of 100%.The mean time spent for operation was(2.7±0.5)hours.The lymphatic leakage point was detected in 5 patients with an effective rate of 83.3%(5/6).The lymphatic fluid amount decreased from preoperative(810.0±708.4)mL to postoperative(355.0±388.3)mL in 24 hours after the operation.The chyle leakage disappeared in a mean time of(12.4±7.5)days.One patient developed pulmonary lipiodol embolism,and after symptomatic treatment the associated symptoms disappeared.ConclusionFor the diagnosis of chyle leakage,inguinal lymph node puncture lymphangiography is minimally invasive,relatively safe and obviously effective,and this technique also carries curative effect for chyle leakage.

关 键 词：乳糜漏 淋巴管造影术 碘化油 诊断 治疗 

分 类 号：R695.8[医药卫生—泌尿科学]