牛奶及脂肪乳剂术前标记胸导管预防食管癌切除术后乳糜胸

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。

Marking thoracic duct with milk or fat emulsion to prevent postoperative chylothorax of the esophogeal cancer

Objective To explore a simpler and more efficient method to prevent postoperative chylothorax of the esophageal cancer.Methods From May,1996 to April,1998,404 patiens were randomly divided into a test group(group A,n=202) and a contrast group(group B,n=202) in Anyang Cancer Hospital.In group A,100 cases were marked with oral milk(group A1) and 102 cases with oral fat emulsion (group A2).Group B were routinely prepared.Results In group A1,86 cases(86.0%) were filled obviously and 14 cases (14.0%) filled ordinarily.In group A2,102 cases (100%) were filled obviously.In group B,thoracic duct can be found in an unfilled state in 61 cases(30.5%). 4 case of postoperative chylothorax were found in group B,but none in group A.There was a statistically significant difference (P<0.05).Conclusions It is a simpler and more efficient method to mark thoracic duct with milk or fat emulsion before operation,which can avoid postoperative chylothorax in patients with esophageal cancer.Fat emulsion has a better effect. [