胸段食管癌术后乳糜胸20例诊治分析

Analysis of diagnosis and therapy of post-operative chylothorax in thoracic esophageal cancer

目的：探讨食管癌术后发生乳糜胸的诊断和治疗方法。方法：回顾性分析20例食管癌患者术后发生乳糜胸的临床资料,20例患者先行保守治疗,治疗5d后胸腔引流量无减少者6例行手术治疗。结果：食管癌术后2-4d出现乳糜胸6例,其中胸腔引流量〉1000ml/d者4例,〈1000ml/d者2例;术后5-12d出现14例,其中〉1000ml/d者6例,〈1000ml/d者8例。20例中保守治疗治愈14例,6例经开胸手术结扎胸导管治愈。结论：食管癌患者术后胸腔引流量持续〉1000ml/d或拔除胸腔引流管后术侧胸腔再次出现大量胸水,结合胸腔引流液乳糜试验结果,是食管癌术后乳糜胸的主要诊断方法;乳糜胸应先行保守治疗,经保守治疗5d后胸腔引流量无减少者选择手术治疗。

Objective： To study the diagnosis and therapy of chylothorax after esophageal cancer resection. Methods： The clinical data was retrospectively analyzed in 20 patients with post-esophagectomy chylothotax. Results： Among 20 cases, 14 case were cured with conservative treatment, 6 case wire cured by oper- ation after unsuccessful conservative treatment. Conclusion： Both conservative and operational treatments can be applied in the therapy of post-esophagectomy chylothorax.