放射性核素淋巴显像定位诊断乳糜外溢

本文应用核素淋巴显像定位诊断１５例乳糜外溢，其中乳糜胸２例，乳糜心包１例，乳糜腹水６例，乳糜腹合并乳糜胸１例，乳糜尿５例，均能显示淋巴系统形态异常或乳糜渗漏部位。本文例举典型病例描述核素显像对不同乳糜渗漏的定位情况，并就诊断中的体会及与Ｂ超、淋巴造影的比较进行了讨论。     

Early endoscopic treatment of chylothorax develops after surgical treatment of lung cancer patients

Objective: Chylothorax which occasionally develops after surgical treatment of lung cancer is generally treated conservatively, and surgical treatment is limited to patients who do not respond well to conservative treatment. Subjects and Methods: Of the 941 lung cancer operation, 6 patients in whom Chylothorax developed after surgical treatment of lung cancer were evaluated for its characteristics and outcome. Results: Two patients underwent thoracoscopic treatment. The duration of drainage was shorter for the 2 patients undergoing chylothorax operation than for the 4 patients who underwent conservative treatment. The mean duration of hospitalization after surgical treatment of lung cancer was 24 days for the patients who underwent conservative treatment alone and 12.5 days for the patients who underwent chylothorax operation. conclusion: Patients in whom chylothorax develops after surgical treatment of lung cancer should promptly undergo operation when the volume of chylous fluid is not decreased by conservative treatment.     

Chylous ascites and chylothorax due to the existence of transdiaphragmatic shunting in an adult with nephrotic syndrome.

Case Chylous ascites is a well-known complication of severe nephroticsyndrome. However, the coexistence of chylous ascites and chylothoraxis rarely reported in adult nephrotic syndrome [1]. A 66-year-old man was diagnosed with nephrotic syndrome     

Mononeuropathy multiplex and chylothorax as earlier manifestations of pulmonary tuberculosis

Mononeuropathy multiplex (MNM) and chylothorax are rare clinical disorders. The concurrence of these two disorders with Mycobacterium tuberculosis infection has not been reported. We herein report a patient who was initially diagnosed with fever of unknown origin and MNM, and then developed chylothorax. Pulmonary tuberculosis was proved 1 month after chylothorax appeared. With low-dose prednisolone 15 mg day(-1) and anti-tuberculosis drugs, all these disorders completely resolved 1 year later.     

An unusual case of chylothorax complicating childhood tuberculosis

Endobronchial tuberculosis (EBTB) and chylothorax are rare clinical disorders. The concurrence of these two disorders as manifestations of childhood pulmonary tuberculosis has not been reported. We report a 4-month-old boy presenting with chylothorax as the initial presentation of tuberculosis that has been successfully treated with octreotide, antituberculosis drugs and steroid therapy.     

乳糜胸的诊断和治疗(3例罕见病例报告)

自1952～1985年收治自发性乳糜胸2例,外伤性乳糜胸1例。文献报道自发性乳糜胸发病率约占同期乳糜胸总数的3.8％,外伤性乳糜胸占1.9％。自发性乳糜胸的治疗原则为首先采用保守疗法,经两周治疗无效者应改为手术治疗。外伤性乳糜胸的治疗原则为每日引流量1000ml以上观察5天或每日引流量500ml以下观察10天不见好转即行手术治疗。目前经胸结扎胸导管已被广泛接受,对顽固性乳糜胸可考虑用滑石粉促进胸膜粘连固定和胸腹腔转流术。     

中西医结合治疗恶性肿瘤术后乳糜胸

目的观察中西医结合治疗恶性肿瘤术后乳糜胸的疗效。方法收集恶性肿瘤开胸术后乳糜胸10例,予以积极纠正全身情况、闭式引流、胸膜黏连,减少乳糜液生成及配合中药加味葶苈大枣泻肺汤(葶苈子、大枣、黄芪、太子参等,1剂/d)治疗,观察其治疗时间及治愈率。结果经保守治疗10例患者均治愈出院,无再手术及死亡病例,治疗时间明显缩短。结论中西医结合治疗乳糜胸可有效缩短治疗时间,提高临床疗效,减轻患者经济负担。     

食管癌术后乳糜胸的原因与诊治(附27例报告)

目的探讨食管癌术后乳糜胸的原因和诊治方法。方法回顾分析我院10年间食管癌切除术后乳糜胸发生的原因与诊治过程。结果食管癌手术2365例,术后发生乳糜胸27例,发生率为1.14%。保守治愈5例,再手术治愈22例。结论食管癌术后并发乳糜胸发生率低,其预防十分重要,术后一旦确诊乳糜胸应积极手术治疗,保守治疗应慎重。     

不同部位及手术方式对胸腔镜肺癌根治术并发乳糜胸的影响分析

目的 探讨不同部位及手术方式（肺段组与肺叶组、左侧与右侧组）对胸腔镜肺癌根治术并发乳糜胸的发生率、治疗和转归的影响。方法 回顾分析2015年1月～2021年12月中国科学院大学宁波华美医院收治2472例肺癌根治术后并发38例乳糜胸,其中肺段切除和肺叶切除各1236例,左侧胸腔镜肺癌根治手术952例,右侧胸腔镜肺癌根治手术1520例,肺段切除+系统性淋巴结根治并发16例乳糜胸,肺叶切除+系统性淋巴结根治并发22例乳糜胸,左侧胸腔镜肺癌手术后并发8例乳糜胸,右侧胸腔镜肺癌手术后并发30例乳糜胸的临床资料。结果 胸腔镜肺癌术后乳糜胸的总发生率为1.54%,肺段组术后乳糜胸的发生率为1.29%,肺叶组为1.78%,两者无显著差异（P=0.32）。左侧胸腔镜肺癌术后乳糜胸的发生率为0.63%,右侧胸腔镜肺癌术后乳糜胸的发生率为2.11%,两者有显著差异（P<0.001）;所有病例均行保守治疗成功,无死亡病例。结论 肺癌术后乳糜胸的发生和肺癌手术部位明显相关,与手术方式无明显相关;肺癌术后乳糜胸的营养支持治疗使保守治疗的有效率不断提高。