富含中链三酰甘油肠内营养联合奥曲肽治疗乳糜性腹水的效果

Successful treatment of chylous ascites following abdominal surgery with medium-chain triglyceride-rich enteral nutrition and octreotide

目的:观察富含中链三酰甘油(MCT)的肠内营养混悬液Nutrison TP-MCT(Nutrison MCT)联合奥曲肽在腹部手术导致的乳糜性腹水治疗中的效果。方法:回顾性分析我科20例因腹部手术导致的乳糜性腹水病人,经Nutrison MCT的EN联合奥曲肽治疗的效果。病人均诊断为术后乳糜性腹水,给予Nutrison MCT和奥曲肽注射剂。记录病人治疗前后腹腔引流液的量、颜色、乳糜试验和三酰甘油浓度。结果:18例病人治疗后3～5 d乳糜试验转为阴性,腹水引流量在治疗后第11天明显下降,但2例病人因乳糜试验持续阳性,且引流量持续>200ml,给予奥曲肽0.8 mg/d联合Nutrison MCT继续治疗3 d后乳糜试验转为阴性,腹水引流量降至200 ml以下。20例病人治疗天数为8～12(9.0±1.4)d。结论:Nutrison MCT联合奥曲肽是治疗术后乳糜性腹水的有效方法。

Objectives： To observe the role of medium-chain and octreotide in the chylous ascites following abdominal surgery triglyceride-rich enteral nutrition Methods： Twety patients with chylous ascites after abdominal surgery had been enrolled in this retrospective study. Nutrison MCT and octreotide 0.6 mg/d were used in 20 patients. The volume, the triglyceride （TG） concentration and the chyle test of ascites were observed and recorded. Results： 20 cases of chylous ascites were cured. The drainage time was 8-12（9.0 ± 1.4） d and the chyle experiment was negative after treatment 3-5 d. 2 patients continued to be given Nutrison MCT and octreotide 0.8 mg/d for 3 days because the chyle test being positive and the volume of ascites being more than 200 ml. Conclusion： Nutrison MCT and octreotide is effective to chylous ascites.