>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息：
甲状腺癌术后乳糜漏综合治疗的临床分析(附8例报告)
作者：刘军1  李新苹1  姚永忠2 
单位：1. 东南大学医学院附属南京江北人民医院 普外科, 江苏 南京 210048;
2. 南京大学医学院附属鼓楼医院 普通外科, 江苏 南京 210008
关键词：甲状腺癌 术后并发症 乳糜漏 综合治疗 
分类号：R736.1;R730.5
出版年·卷·期（页码）：2016·35·第三期（380-383）
摘要：

目的:评估甲状腺癌术后乳糜漏综合治疗的效果,探讨临床上有效治疗乳糜漏的方法。方法:我科2013年3月至2014年3月期间共收治426例行甲状腺癌颈淋巴结清扫术的患者。对术后出现乳糜漏的患者先行低脂饮食、持续负压吸引和局部加压包扎等非手术治疗,无效后行手术治疗。观察治疗前后患者颈部引流量及切口愈合情况,并对这些患者的临床资料进行总结分析。结果:共出现乳糜漏患者8例,占总数的1.9%,其中4例经非手术治疗后治愈,另4例经非手术治疗加手术治疗后治愈。结论:灵活使用非手术治疗及手术治疗可快速有效治愈甲状腺癌术后乳糜漏。

Objective:To evaluate the comprehensive treatment in the management of chylous fistula after operation of thyroid carcinoma and to investigate the effective treatment for chylous fistula. Methods:426 patients with thyroid carcinoma following neck lymph node dissection were admitted to our department from March 2013 to March 2014.Reoperation and Non-surgical treatment including low-fat diet, continuous negative pressure suction and local package compression bandage were used in treatment of 8 cases of chylous fistula after operation of thyroid carcinoma. The fluid volume and wound healing were investigated. The clinical data were summed and analyzed. Results:A total of 8 cases developed chylous fistula complication, about 1.9%. 4 cases were cured with non-surgical treatment. Other 4 cases were finally cured by reoperation and non-surgical treatment. Conclusion:Flexibility in the use of non-surgical treatment and reoperation can cure chylous fistula after operation of thyroid carcinoma rapidly.
参考文献：

[1] CARON N R,CLARK O H.Papillary thyroid cancer:surgical management of lymph node metastases[J].Curr Treat Options Onco,2005,6(4):311-322.
[2] ERISEN L,COSKUN H,BASUT O.Objective and early diagnosis of chylous fistula in the postoperative period[J].Otolaryngol Head Neck Surg,2002,126(2):172-175.
[3] GREGOR R T.Management of chylefistulization in association with neck dissection[J].Otolaryngol Head Neck Surg,2000,122(3):434-439.
[4] 苗万青,鞠忠祥,宋海平,等.双侧全切+颈淋巴结清扫在乳头状甲状腺癌治疗中的价值[J].临床外科杂志,2009,17(10):709.
[5] THOMAS L K.Surgical complications of thyroidectomy[J].Otolaryngol Head Neck Surg,2003,14(2):74-79.
[6] COSKUN A,YILDIRIM M.Somatostain in medical management of chyle fistula after neck dissection for papillary thyroid carcinoma[J].Am J Otolaryngol,2010,31(5):395-396.
[7] LUCENTE F E,DIKTABAN T,LAWSON W,et al.Chyle fistula management[J].Otolaryngol Head Neck Surg,1981,89(4):575-578.
[8] ANTONIO B,KASIRAJAN S,JOHN D C.The community management of chylous fistula using a pancreatic lipase inhibitor (orlistat)[J].Laryngoscope,2006,116(10):1934-1935.
[9] KANNAN R R,MAHAJAN V,AYYAPPAN S.Management of chyle fistulae following surgery in the neck[J].Indian J Cancer,2001,38(2-4):117-120.
[10] 全竹富,何长生,汪志明,等.营养支持在胰源性腹水治疗中的应用(附1例报告及文献总结)[J].场外与肠内营养,2005,12(6):355-360.
[11] 刘方舟,虞同华,赵卫平,等.生长抑素对颈淋巴结清扫术后乳糜漏的疗效观察[J].中国肿瘤外科杂志,2013,5(7):85-87.
[12] 李伟汉,张浩,刘平贤.奥曲肽在甲状腺癌根治术后乳糜漏治疗中的应用[J].医师进修杂志,2005,28(3):36-37.
[13] 王弘之,殷之平.持续强负压吸引引流治疗颈乳糜漏的模拟实验[J].中国癌症杂志,1999,9(3):249-251.
[14] GUNNLAUGSSON C B,IANNETTONI M D,BO Y,et al.Management of chyle fistula utilizing thoracoscopic ligation of the thoracic duct[J].ORL,2004,66(3):148-154.
[15] STEELE S R,MARTIN M J,MULLENIX P S,et al.Intraoperative use of isosulfan blue in the treatment of persistent lymphatic leaks [J].Am J Stag,2003,186(1):9-12.
[16] CHEN E,ITKIN M.Thoracic duct embolization for chylous leaks [J].Semin Intervent Radiol,2011,28(1):63-74.
[17] 樊玉文,张园,赵卫平,等.超声刀在甲状腺癌颈淋巴结清扫术中的应用研究[J].现代医学,2011,39(2):175-178.
服务与反馈：
【文章下载】【发表评论】【查看评论】【加入收藏】
提示：您还未登录，请登录！点此登录
您是第 414173 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话：025-83272481 83272483
电子邮件： bjb@pub.seu.edu.cn

苏ICP备09058364