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目的证明腹腔束带加压对于食管癌或贲门癌术后乳糜腹的有效性,并探讨其使用的条件和优缺点。方法总结四川大学华西医院胸外科2009~2013年行食管癌或贲门癌切除术的3 859例患者中术后出现乳糜腹的4例患者接受加压治疗的情况,对其治疗经过和结局进行分析,其中男3例、女1例,年龄59~68岁。结果 4例患者中,3例加压成功患者均在两周内治愈,随访超过1年时间未见乳糜腹复发,1例患者因腹部加压后乳糜液持续漏入胸腔,导致无法成功加压,治疗失败,最终通过再次手术治愈。结论在保证腹腔是一个封闭空间及足够压力和时间的前提下,加压治疗对腹部术后乳糜腹有效,且无创、时间短、风险低及不需禁食,其缺点是患者治疗前期有腹腔加压的不适感。
Objective To demonstrate the effectiveness of celiac banding for postoperative chylothorax in patients with esophageal or cardiac cancer and to explore the conditions and advantages and disadvantages of the use. Methods A total of 3 859 patients who underwent esophagectomy or cardia cancer resection from 2009 to 2013 in Huaxi Hospital of Sichuan University were enrolled in the study. Their treatment and outcomes were analyzed , Including 3 males and 1 females, aged 59 to 68 years. Results Of the 4 patients, 3 of the 3 successful patients were cured within two weeks. No recurrence of chylothorax was observed after more than one year of follow-up. One patient sustained leakage of chylous fluid into the thorax due to abdominal pressure, resulting in failure to be successfully pressurized , Treatment failed, and finally cured again by surgery. Conclusion Under the premise of ensuring the abdominal cavity is a closed space and enough pressure and time, pressure treatment is effective and effective in the treatment of postoperative abdominal paralysis, non-invasive, short time, low risk and no fasting. The disadvantage is that the patients have abdominal cavity Pressure discomfort.