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目的 探讨一种简单、有效的预防食管癌切除术后乳糜胸的方法。方法 1996年 5月～ 1998年 4月我科住院食管癌病人 ,无进食梗阻者 ,随机分为试验组 (A组 )和对照组 (B组 )各 2 0 2例。A组前 10 0例术前口服牛奶进行标记 (A1组 ) ,后 10 2例术前口服 2 0 %脂肪乳剂注射液进行标记 (A2组 ) ,B组术前常规准备。术中观察各组胸导管充盈状态和损伤情况 ,术后统计各组乳糜胸及其它并发症 ,X2 检验进行统计分析。结果 A1组明显充盈 86例 (86 .0 % ) ,一般充盈 14例 (14 .0 % ) ;A2组均明显充盈 (10 0 % ) ;B组能见到胸导管 6 1例 (30 .5 % ) ,但均呈不充盈状。术后乳糜胸A组 0例 ,B组 4例 (2 .0 % ) ,两组比较有显著差异 (P <0 .0 5 )。结论 牛奶及脂肪乳剂术前标记胸导管方法简单、可靠 ,能基本避免食管癌术后乳糜胸的发生。以脂肪乳剂效果更佳。
Objective To explore a simple and effective method to prevent chylothorax after resection of esophageal cancer. Methods From May 1996 to April 1998, patients with esophageal cancer in our department who had no eating obstruction were randomly divided into experimental group (A group) and control group (B group). The first group of 100 patients in group A received oral pre-operative milk labeling (group A1), and the remaining 102 patients were pre-administrated orally with 20% fat emulsion injection (group A2). Group B was routinely pre-operatively prepared. Intraoperative observation of thoracic duct filling status and injuries in each group, postoperative statistics of chylothorax and other complications in each group, X2 test for statistical analysis. Results A1 group was significantly filled with 86 cases (86.0%), and generally filled with 14 cases (14.0 %); A2 group was significantly filled (100%); B group could see thoracic duct in 61 cases (30.5 %), but they are not full. Postoperative chylothorax group A 0 cases, group B 4 cases (2.0%), there was a significant difference between the two groups (P <0. 05). Conclusion The method of labeling thoracic ducts before milk and fat emulsion is simple and reliable. It can basically avoid the occurrence of chylothorax after esophageal cancer surgery. It works better with fat emulsions.