肺癌根治术后乳糜胸发生的相关因素分析

目的 综合评价肺癌根治术后乳糜胸的诊治及疗效.方法 回顾性分析肺癌根治患者1473例的临床资料,并发乳糜胸者36例,分析乳糜胸发生的相关临床因素及临床特征.结果 肺癌根治术后乳糜胸发生率为2.4％;乳糜胸组的男性(83.3％)、吸烟史(75.0％)、肺部疾病史(41.7％)、糖尿病史(44.4％)、鳞癌(55.6％)、...

Analysis of the related factors of chylothorax after radical resection of lung cancer

Objective To evaluate the clinical diagnosis and treatment of chylothorax after radical resection of pulmonary malignant tumor.Methods The clinical data of 1473 patients with radical resection of lung cancer were analyzed retrospectively,and 36 cases had postoperative chylothorax.The clinical factors and characteristics of chylothorax were analyzed.Results The incidence of chylothorax was 2.4%after radical resection of lung cancer.The incidences of chylothorax in men(83.3%),smoking history(75.0%),lung disease history(41.7%),diabetes history(44.4%),squamous cell carcinoma(55.6%),N2 station metastasis(30.6%)were higher than those without chylothorax(P<0.05).The right upper lobectomy in the chylothorax group was significantly higher than that in the non chylothorax group(41.7%vs 27.8%,P<0.05),and the patients at stageⅡ/Ⅲwere significantly more than those in the non chylothorax group(86.1%vs 32.3%,P<0.05).In 36 chylothorax patients,the content of triglyceride in pleural fluid was 123-1015 mg/dl,with an average of 367.4±202.6 mg/dl.The volume of pleural drainage was 320-1750 mL,with an average of(823.3±516.5)mL per 24 hours.There was no significant difference in the content of triglyceride in pleural fluid between the conservative group and the operation group,while the 24-hour chest drainage was significantly lower than the latter(550.5 mL vs 1233.3 mL),and the days with chest tube were significantly shorter than the latter(6.8 d vs 13.2 d).Conclusion For those with right lung cancer,men,smokers,basic lung diseases or diabetes,and those with large lymph nodes in N2 station,more careful and cautious operation should be carried out to avoid chylothorax.Chylothorax can be cured by conservative treatment.For those whose drainage volume is more than 1000 mL/24 h,or whose pleural fixation treatment lasts for 5 days without improvement,active surgical intervention is recommended.