胸部肿瘤手术后并发乳糜胸45例

40 cases of the patients with chest tumor complicated postoperative chylopleura

目的 总结胸部肿瘤手术后并发乳糜胸的诊治经验。方法 回顾分析 1969年 12月至 1994年 12月胸部肿瘤术后乳糜胸的发生情况及诊断与治疗。结果 手术治疗 23例， 17例治愈。 6例因全身衰竭和并发吻合口瘘死亡；保守治疗 17例， 16例治疗，死亡 1例。结论 乳糜胸患者经保守治疗 3～ 5天乳糜液量仍超过 1 000 ml，而无减少趋势者应立即手术治疗，关键在于预防，对术中高度怀疑胸导管损伤者，应毫不迟疑地在膈上行低位胸导管结扎术。

Objective:To summarize the experience of diagnosis and treatment about the patients with chest tumer complicated postoperative chylothorax.Methods:To retrospectively analyse the incidence,the diagnosis and the treatment of the patients with chest tumor complicated postoperatine chylothorax from December 1969 to Decmeber 1994.Results:The patients were divided into two groups.Group A:operative treatment of 23 cases,17 cases were cured and 6 cases died of general failure or anastomotic Leakage.Group B:conservative treatment of 17 cases,16 cases were cured and one died.Conclusion:The patients complicated postoperative chylothorax must be immediately operated if their chylus will be more than 1000 millihtre without decreasing current throhgh conservative treatment for three to five days.The key prevention,we muat perform the Low supradiaphragmatic Ligation of thoracic duct without doubt if we highly suspect the thorcic oubt to be injured. [