强负压吸引治疗8例颈淋巴结清扫术后乳糜瘘

背景与目的颈部乳糜瘘是颈部手术后的并发症之一,其产生机制与其特定的解剖位置及变异密切相关,有关其治疗的意见仍有分歧。本文总结8例颈清扫术后并发乳糜瘘患者采用强负压吸引和饮食处理的临床经验,以评价其疗效。方法全部病例在确诊为乳糜瘘后立即采用强负压(-50～-30kPa)吸引,嘱禁食并给予合理的静脉营养。结果7例患者经此保守治疗痊愈,未出现其他严重并发症;1例无效,采用胸大肌肌瓣填塞。结论强负压吸引和合理的饮食处理有可能是颈清扫术后并发乳糜瘘早期处理较为理想且安全的保守疗法之一。

Validity of high negative pressure drainage for chylous fistula after neck dissection: a report of eight cases

BACKGROUND & OBJECTIVE: Chylous fistula, a severe complication after operation on neck, has close correlation with definite anatomical position and variation. Its treatment remains controversial. This study was to evaluate the validity of high negative pressure drainage for chylous fistula after neck dissection. METHODS: A treatment of high negative pressure (-30 to -50 kPa) drainage, fasting, and reasonable venous nutrition was applied to 8 patients with postoperative chylous fistula. RESULTS: Of the 8 patients, 7 recovered smoothly without severe complication, and pectoralis major muscle flap was adopted to cure the failed one. CONCLUTION: A treatment of high negative pressure drainage and reasonable diet is effective and safe for chylous fistula at early stage.