乳糜漏的诊断与处理方式的探讨

Discussion on the diagnosis and treatment of chylosis

目的探讨乳糜漏的正确诊断及最佳处理方式。方法我院自2014年1月～2018年2月间共行功能性及根治性颈淋巴结清扫手术126例,其中5例术后明确诊断为乳糜漏,回顾性分析5例患者的治疗方法,对比保守治疗与手术治疗的效果,进一步明确保守治疗及手术治疗的指征。结果 5例患者中4例患者经保守治疗痊愈,1例患者保守治疗后引流液仍逐渐增多故急诊行手术治疗,5例患者经治疗后均痊愈出院,定期随访均未复发。结论乳糜漏是较难处理的一种术后并发症,以保守治疗为主,但要严密观察和及时处理乳糜漏引起的全身水、电解质、营养状态的紊乱。如漏出液量短期内未见减少、全身器官功能紊乱、营养状态发生障碍时,应及时采用外科手术探查修复乳糜漏为宜。

Objective Explore the correct diagnosis of chyle leakage and the best way to deal with. Methods Functional and radical was cleaning procedure in 126 cases from January 2014 to February 2018,including 5. cases of postoperative clear diagnosis of chyle leakage,5cases were retrospectively analyzed in patients with treatment, compared the effect of conservative treatment and surgical treatment,make a clear definition of the indications of conservative treatment and surgical treatment.Results 4 patients were cured by conservative treatment,1drainage is still increasing liquid after conservative treatment in patients with emergency surgical treatment,the hospital were recovered after treatment,5 patients has not been regular follow-up recurrence.Conclusion chyle leakage is one of the more difficult the postoperative complications,with conservative treatment is given priority to,but want close observation and timely treatment chyle leakage caused by the body water,electrolyte,the nutrition state of disorder. Such as leaking fluid volume in the short term no less,the whole body organ dysfunction,nutritional status when the obstacle,the probe should be adopted timely surgery to repair chyle leakage is advisable.