多径路淋巴管静脉内套入术治疗乳糜尿的效果观察

MICROSURGICAL TREATMENT OF CHYLURIA WITH MULTIROUTE INSERTION OF LYMPHATICS INTO VEINS

本文报告采用多径路淋巴管静脉内套入术治疗乳糜尿３０例，结果术后出院时乳糜尿消失２５例（８３．３％），好转１例（３．３％），总有效率为为８６．６％。出院后１～２年内复查３０例，乳糜尿消失２１例（７０．０％），好转４例（１３．３％），总有效率为８３．３％。该手术的特点是缝线不通过淋巴管管腔；不受淋巴管和静脉口径粗细的影响；勿需切断静脉，可利用一条静脉的不同方位或多个部位的径路，采用并列、集束、电缆等多种套入方式，使吻合淋巴管数目增多，吻合口合计口径值大，淋巴分流量增加，并减少了显微外科技术上的难度。该手术由于部位表浅，术式简单便于推广应用。

Multiroute insertion of lymphatics into veins by microsurgical techniques was employed for the treatment of 30 cases of chyluria. After the operation, 25 cases(83.3%) showed disappearance of chyluria,1 case(3.3%) was improved,with the total effective rate of 86.6%(26/30). Reexamination of these 30 cases 1-2 years after operation showed that 21 cases(70%) had the chyluria disappeared, 4 cases(13.3%) had improved, with the effective rate of 83.3%. The operation has advantages of not essential to cut veins, suturing not going through lymphvessels, and that different positions or different sites of one vein can be inserted with lymphatics in the form of bundles or parallelling side by side etc. irrelevant to calibres of vein and lymphatics. Therefore,the number of lymphatics anastomosed increased,the total calibre was enlarged and lymph circulation increased. This operation took place in the superficial site,and was easy to perform and popularise.