铜绿假单胞菌注射液术区注射治疗颈淋巴结清扫术后顽固性高流量乳糜漏二例及文献复习  

Pseudomonas aeruginosa injection for treatment of refractory high-output chyle leakage after cervical lymph node dissection:report of two cases with a literature review

作　　者：刘皖 赵婷婷 魏明辉 Liu Wan;Zhao Tingting;Wei Minghui(Department of Head and Neck Surgery,National Cancer Center/National Research Center for Cancer/Cancer Hospital&Shenzheng Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen 518116,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院头颈外科,深圳518116

出　　处：《中华临床医师杂志(电子版)》2024年第10期926-930,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：中国医学科学院肿瘤医院-深圳医院合作基金项目(CFA202202014)

摘　　要：目的总结铜绿假单胞菌注射液治疗颈部顽固性高流量乳糜漏的临床经验。方法本研究回顾分析了中国医学科学院肿瘤医院深圳医院头颈外科收治的2例甲状腺癌颈淋巴结清扫术后顽固性高流量乳糜漏患者的临床资料,其均为初治手术患者。2例患者均考虑为左侧颈根部胸导管或其分支破裂所导致的乳糜漏,患者24 h最高引流液量均超过1000 ml。结果患者保守治疗效果不佳,均接受了铜绿假单胞菌注射液经左侧颈部引流管逆行注射治疗,最终2例患者均顺利拔管、痊愈出院,无严重并发症及后遗症。结论铜绿假单胞菌注射液术区注射治疗颈部顽固性高流量乳糜漏效果较好,安全性较高,能明显缩短乳糜漏病程。Objective To summarize our clinical experience with Pseudomonas aeruginosa injection in the treatment of refractory high-output chyle leakage in the neck.Methods In this study,we retrospectively analyzed the clinical data of two patients with refractory high-output chyle leakage after cervical lymph node dissection for thyroid cancer admitted to Cancer Hospital&Shenzheng Hospital,Chinese Academy of Medical Sciences,of which 1 was female and 1 was male.Both patients underwent primary surgery.Both patients were considered to have chyle leakage caused by the rupture of the thoracic duct at the left neck,and the maximum daily drainage volume exceeded 1000 ml.Results The patients had poor response to conservative therapy,and both of them received retrograde injection of Pseudomonas aeruginosa injection through the left cervical drain,and were finally discharged from the hospital without serious complications and sequelae.Conclusion Pseudomonas aeruginosa injection in the operative area is effective and safe in the treatment of refractory high-output chyle leakage in the neck,and it can significantly shorten the duration of chyle leakage.

关 键 词：铜绿假单胞菌注射液 乳糜漏 颈淋巴结清扫术 甲状腺癌 

分 类 号：R736.1[医药卫生—肿瘤]