支气管肺癌根治术后并发乳糜胸的诊治分析

目的?探讨支气管肺癌根治性切除术后发生乳糜胸并发症的临床诊治方法。方法?收集2015年1月至2018年2月江苏大学附属医院胸心外科行支气管肺癌根治性切除术后发生乳糜胸并发症11例患者的临床资料。其中4例24 h 胸腔引流量250～400 m1，予禁油腻食物并予以高蛋白支持；6例400～700 m1予生长抑素并间隙性夹闭胸腔闭式引流管；1例24 h 胸腔引流量700～1200 m1，予胸腔灌注金葡素注射液。结果?11例经保守治疗全部治愈。所有患者拔管后胸闷、气促、心率加快症状恢复，3 d后复查胸片无明显积液。结论?支气管肺癌根治性切除术中行系统淋巴结易清扫损伤胸导管分支及交通淋巴管引起乳糜胸并发症，采取个体化精准治疗，均可通过保守治疗治愈。

Clinical Management on Chylothorax of Post-operation of Bronchial Carcinoma

Objective To discuss the Clinical management of Chylothorax of Post-operation of Bronchial Carcinoma resection with sweeping Iymph nodes．Methods The Clinical materials of 11 cases were analyzed retrospectively which were taken operrtionj in the affiliate hospital of Jiangsu university from January 2015 to January 2018．Reslllts All of the 11 cases were cured by conservative treatment,Of which 4 cases were fasting greasy food and cured after high protein support；6 cases were treated with somatostatin and gap closure closed thoracic drainage tube cure; 1 case of thoracic perfusion with cisplatin and high concentration was cured.Conclusion Radical resection of bronchial lung cancer in the system is easy to clean the lymphatic branches of the thoracic duct and traffic lymphatic vessels caused by chylothorax complications, combined with the disease, to individualized treatment, mostly cured by conservative.