肺切除术后乳糜胸的临床诊断与治疗

目的：探讨肺切除术后乳糜胸的持点和诊治经验。方法：1989年1月～2005年12月共收治肺切除术后乳糜胸16例，其中肺叶切除术后10例，令肺切除术后2例，肺楔型切除术后4例。16例患者中行保守治疗10例．手术治疗6例。结果：16例患者均痊愈，无一例死亡，其中全肺切除术后2例均因营养障碍再次手术治疗，经结扎胸导管而痊愈；肺楔型切除术后4例均经保守治疗，效果差，最终经手术治疗而治愈。结论：肺切除术后乳糜胸应首选保守冶疗，效果不佳者需手术治疗。肺切除术中注意缝合技术，正确辨认、结扎胸导管是减少乳糜胸发生的关键。

Diagnosis and treatment of the patients with chylothorax after pneumonectomy

Obiective: To evaluate the clinical feature and diagnosis and therapy of the patients with chylothorax ofter pneumonectomy. Methods: Retrospective analysis on 16 patients treated from Jan, 1989 to Dec, 2005. They are 10 cases of pulmonary lobectomy, 4 cases of wedge-shape excision of lung and 2 cases of total pneumonectomy. Of all cases, 10 cases underwent conservative treatment, 6 cases were given operation. Results: All cases were cured perfectly without mortality, The 2 cases of total pneumonectomy took ligature of thoracic duct due to malnutritious, the 4 cases of wedge-shape excision were well enough after treatment of conservation, 4 out of 10 cases of pulmonary lobectomy were treated conservatively followed operation due to invalidity. Conclusion: Conservative treatment should be the first consideration for patients with chylothorax after pulmonectomy, perfect pneumonorrhaphy and recognization of thoracic duct in the operation is the key to keep patients from chylothorax.