甲状腺癌颈廓清术并发乳糜漏18例临床分析

目的：探讨甲状腺癌颈廓清术并发乳糜漏的预防、诊断及治疗效果。方法：术中并发乳糜漏4例行术中结扎、缝扎、局部肩胛舌骨肌填塞治疗；术后并发乳糜漏14例中6例行保守治疗，8例行再次手术（打开手术切口，找到漏口，结扎、缝扎或局部肩胛舌骨肌填塞）。结果：乳糜漏的发生率为3．47％；术中并发乳糜漏4例经手术治疗未出现乳糜漏；术后并发乳糜漏14例中6例经保守治疗治愈，术后8例经再次手术治愈。结论：对甲状腺癌颈廓清术并发的乳糜漏应及早诊断，术中应加强预防．出现乳糜漏后应及时采取适当方法处理。

A clinic analysis of the chylous fistula after neck dissection by 18 cases

Objective: To explone the diagnose and therapy of the chylous fistula after neck dissection in thyroid carcinoma.Method: Four cases of them in operation were treated with ligation in,sewing firm,the ramming of local omohyroid;6 of them after operation were treated with conservative treatment,8 cases were treated through the surgical operation again(opening the operation incision,looking for the point of the chylous fistula,ligating in,sewing firm,ramming with local omohyroid).Result: The occurrence rate of the chylous fistula after neck dissection was 3.47%;4 cases of them in operation were cured after ligation in,sewing firm,the ramming of local omohyroid,the chylous fistula after neck dissection did not appear;6 cases of them after operation was cured by conservative treatment,8 cases were cured through the surgical operation again.Conclusion: Chylous fistula after neck dissection in thyroid cancer should be diagnosed early,should strengthen the prevention and adopt appropriate methods processing in time after its appearing.