复杂性先天性心脏病手术后乳糜胸的治疗体会

目的:探讨先天性心脏病手术后乳糜胸的原因及治疗。方法:回顾性分析总结我院2000年10月至2005年3月期间先天性心脏病手术后乳糜胸16例临床资料。结果:16例先心病手术后乳糜胸患者中15例为手术中不同程度的损伤胸导管或其分支所致,经持续胸腔引流、胃肠禁食、静脉内营养等保守治疗后,仅1例在术后10天内因胸腔引流量持续大于10 ml／kg·d,而再次手术结扎胸导管,其余15例均由保守法治疗治愈(93．7％)。结论:先天性心脏病手术后并发的乳糜胸经保守治疗多可痊愈。

Management of postoperative chylothorax in patients with congenital heart disease

Objective: To investigate the causes and therapy of postoperative chylothorax (PPC) in patients with congenital heart disease (CHD). Methods: The data of 16 cases with PPC in CHD patients were analysed. Results:From Oct. 2000 to Mar. 2005, PPC developed due to injuring main thoracic duct and its branches during thoracic precedure in 16 of 16 CHD patients. All patients were conservatively treated including low-fat diet, total parenteral nutrition and pleural drainage. Except one patient, whose chyle leakage remained much than 500 ml in 24 hours after 10 days,treated by ligation of main thoracic duct,another 15 PPC patient all cured (93.7%). Conclusion: Postoperative chylothorax in CHD patients may mainly cured by conservatively treat.