甲状腺癌术后乳糜漏的诊断与治疗

来源 :中国临床实用医学 | 被引量 : 0次 | 上传用户:leon7352
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目的:探讨甲状腺癌术后乳糜漏的诊断与治疗。方法:选取2015年2月至2019年8月中山大学附属第一医院乳腺甲状腺外科收治的21例行甲状腺根治癌术后出现乳糜漏的患者,对其一般资料进行回顾性分析,男4例,女17例,年龄(42±12)岁,年龄范围为21~58岁。根据患者术中情况的不同,分别行保守治疗、胸导管漏口缝扎术治疗及胸腔镜下胸导管结扎术治疗,并分析不同治疗方法的选择依据及治疗效果。结果:13例保守治疗治愈;6例行胸导管漏口缝扎术治疗,4例治愈,2例失败后改用胸腔镜下行胸导管结扎术治愈;2例胸腔镜下行胸导管结扎术治愈。结论:术中熟悉颈部解剖、彻底结扎淋巴管及避免损伤胸导管是预防术后乳糜漏的关键;术后常规予以持续负压吸引、局部加压包扎和早期低脂饮食有利于减少术后乳糜漏发生。“,”Objective:To investigate the diagnosis and treatment of chyle leakage after thyroidectomy.Methods:A retrospective study was performed on 21 cases of patients with chylous leakage after radical thyroidectomy who were admitted to the First Affiliated Hospital of Sun Yat-sen University from February 2015 to August 2019.The general data were retrospectively analyzed, including 4 males and 17 females, ranged(42±12)years old, ranging from 21 to 58 years old.According to the different intraoperative conditions of the patients, conservative treatment, thoracic duct leaky suture and thoracoscopic catheter ligation were performed, respectively, and the selection basis of different treatment methods and therapeutic effects were analyzed.Results:The 13 cases were cured by conservative treatment; 6 cases were treated by thoracoscopic ligation of thoracic duct leakage, 4 cases were cured, 2 cases were treated by thoracoscopic ligation after failure; 2 cases were cured by thoracoscopic ligation of thoracic duct.Conclusion:Be familiar with neck anatomy, complete ligation of lymphatic vessels and avoidance of injury of thoracic ducts are the key to prevent postoperative chylous leakage.The routine application of continuous negative pressure suction, local compression dressing and early low-fat diet is beneficial to reduce the occurrence of postoperative chylous leakage.
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