一例猫特发性乳糜胸保守疗法与胸导管手术治疗的效果比较  

Comparison of the Conservative Therapy and Thoracic Duct Surgery for Feline Idiopathic Chylothorax

作　　者：刘敏[1] 李宁 朱前磊[1] 靳冬[1] Liu Min;Li Ning;Zhu Qianlei;Jin Dong(Henan Center for Animal Disease Prevention and Control,Zhengzhou 471000,Henan,China;Anyang Center for Animal Disease Prevention and Control,Anyang 455000,Henan,China)

机构地区：[1]河南省动物疫病预防控制中心,河南郑州471000 [2]安阳市动物疫病预防控制中心,河南安阳455000

出　　处：《中国动物检疫》2024年第10期107-111,共5页China Animal Health Inspection

摘　　要：2023年9月19日,一只1岁6个月雄性狸花猫因呼吸急促、胸腔积液转至河南省启点医院就诊。抽吸胸腔积液可见淡粉色、不透明的乳糜。经过血常规、血液生化、血清淀粉样蛋白A(SAA)、X线、心脏超声等检查以及猫心脏疾病快速检测和胸腔积液分析,最终确认为特发性乳糜胸。先采用每日低脂饮食,口服芦丁片以及抽吸胸腔积液的保守疗法,然后选择胸导管结扎术手术治疗。保守治疗后,胸腔积液量仍持续增多;手术治疗后,进行常规对症用药与疼痛管理,胸腔积液量逐渐减少,持续跟进近3个月预后良好。结果说明保守治疗对该病例的疗效不佳,胸导管结扎术是治疗乳糜胸安全有效的方式。从病例术后产生积液的量和持续时间来看,如能合并心包切除术,更能有效缓解疼痛,减少术后并发症,加快恢复。本文为猫特发性乳糜胸的鉴别与诊断以及治疗方式选择提供了参考。On September 19,2023,a male cat at the age of 1.5 years with polypnea and pleural effusion was referred to Qidian Hospital in Henan Province.Light pink and opaque chyle were observed through thoracentesis,which was finally determined as idiopathic chylothorax after examination by routine blood test,blood biochemistry test,serum amyloid A(SAA)detection,X-ray and cardiac ultrasound,as well as rapid detection of feline heart diseases and pleural effusion analysis.The conservative therapy including daily low-fat diet,oral rutin tablets and thoracentesis was firstly used,followed by thoracic duct ligation surgery.The pleural effusion continued to increase after the conservative therapy,but gradually reduced when routine symptomatic administration and pain management were conducted after surgery,and a favorable prognosis was observed during the follow-up for nearly 3 months.In conclusion,the case was effectively treated by thoracic duct ligation surgery rather than the conservative therapy.Based on the amount and duration of effusion after surgery,pain could be more effectively relieved to reduce any postoperative complications and speed up recovery,if a pericardiectomy could be used together.A reference was provided for the identification and diagnosis of feline idiopathic chylothorax and for the selection of a treatment method.

关 键 词：特发性乳糜胸 保守治疗 胸导管结扎术 猫 

分 类 号：S851[农业科学—预防兽医学]