医用生物胶黏合封堵乳糜瘘10例的临床效果观察

Observation on the Clinical Efficacy of Compont Medical Adhesive to Cohere Thoracic Duct Fistula after Neck lymph Node Dissection: 10 Cases

目的：评价颈淋巴清扫术中应用医用生物胶黏合周围自体肌肉组织封堵胸导管瘘口预防术后乳糜瘘的临床疗效及安全性。方法：选择2005年1月~2012年4月我科收治的10例口腔癌患者,在颈淋巴清扫术中发现并确诊为乳糜瘘后,立即行瘘口缝扎并应用医用生物胶黏合周围自体肌肉组织封堵瘘口,观察其临床效果及不良反应的发生情况。结果：经此方法治疗后,10例患者术中术后均未出现乳糜瘘及其他严重并发症;2例患者经此法治疗无效后,二次手术探查行瘘口缝扎及应用医用生物胶黏合封堵治疗后有效。术后随访10例患者3个月均未发现有乳糜瘘复发,亦未出现局部刺激反应及变态反应。结论：术中医用生物胶黏合封堵胸导管瘘口是预防颈淋巴结清扫术后乳糜瘘理想、安全的治疗方法。

Objective： Evaluate the clinical curative and security of Compont Medical Adhesive to cohere thoracic duct fistula in order to cure the persons appearing chylous fistula after neck dissection. Methods： After all of the 10 patients who were treated from January 2005 to April 2012 were found and diagnosed with chylous fistula in surgery, sutured the wounds combined with medical adhesive sticking immediately. Observe the clinical efficacy and adverse reaction. Results： No chylous fistula and other severe complications occurred during and after the operation with this method. Of all the 10 patients, 2 cases were failed and reoperation were adopted to cure the failed cases. Follow up 3 months, no recurrent chylous fistula occurred as well as local stimulation and allergy. Conclusion： It is suggested medical adhesive to cohere thoracic duct fistula may be an effective and safe way for the persons who appear chylous fistula after neck lymph node dissection.