胸腔内注射滑石粉治疗乳糜胸

Intrapleural administration of talcum powder in chylothorax

目的回顾性分析1990年至2003年16例乳糜胸病例,探讨经胸腔内注射滑石粉治疗乳糜胸的技术方法和疗效等。方法16例患者根据抽出的胸腔渗出液进行苏丹Ⅲ染色和甘油三酯定量检查确诊为乳糜胸。对滑石粉做高温灭菌,用生理盐水溶液将2g滑石粉稀释至20ml,经胸腔穿刺或胸引管注射入胸腔,可重复1～2次。胸腔内注射滑石粉后乳糜量每天>1000ml持续3～4d者,则采取手术结扎胸导管+胸腔内涂抹滑石粉治疗。结果治愈14例,死亡2例。其中胸腔内注射滑石粉治疗11例,治愈11例。手术结扎胸导管+胸腔内涂抹滑石粉治疗5例,治愈3例,死亡2例。结论胸腔内注射滑石粉治疗乳糜胸疗效肯定。

Objective To evaluate the efficacy and safety of intrapleural administration of talcum powder as an agent for pleurodesis in patients with chylothorax. Methods During 1990 to 2003, 16 patients with chylothorax performed the treatment of talcum. The diagnosis of chylothorax was confirmed by Sudan - staining and quantitative detection of triglyceride. The talcum solution consisting of a mixture of 2 g autoclaving talcum and 20 ml normal saline solution was injected into patients thoracic cavity,then the patients were asked to turn the body over repeatedly and continuously for 30 minutes. The injection of talcum could be repeated 1 to 2 times. If the chyle drainage was still more than 1 000 ml per day, the ligation of thoracic duct would be performed. Results Of the 16 patients there were 14 cured and 2 died.Among them,11 patients were treated with intrapleural administration of talcum powder and all cured;5 patients treated with ligation of thoracic duct and intrapleural dauting talcum powder and 2 died from postoperative complication. Conclusion The intrapleural administration of talcum powder is definitely effective in the treatment of chylothorax.