胃十二指肠手术后淋巴漏及其营养支持治疗

Postoperative gastro-duodenal lymphatic leakage and nutritional support

胃十二指肠术后淋巴漏主要是由于手术或其他创伤因素导致胸导管或腹腔淋巴管破裂使淋巴液进入胸、腹腔所致。一旦发生高流量淋巴漏时,经常导致脂肪、蛋白质、水及电解质的丢失,病人出现营养不良而衰竭;另外淋巴液中含有大量的淋巴细胞,随着淋巴液丢失可引起体内淋巴细胞功能低下而继发感染,不仅延缓康复时间,严重者可造成病人死亡。淋巴漏后积极行营养支持治疗可帮助病人顺利康复。本文主要从淋巴漏发生的原因、临床表现、诊断和治疗这几个方面对术后淋巴漏进行阐述分析。

Lymphatic leakage after gastro-duodenal surgery is mainly caused by surgical or other trauma factors,leading to rupture of lymphatic vessels in thoracic duct or celiac cavity,causing lymphatic fluid into chest and abdominal cavity.The flow with high lymphatic leakage often leads to fat,protein,water and electrolyte loss.On the one hand,malnutrition and failure appear;on the other hand,the loss of lymphatic fluid containing a large number of lymphocytes can cause lymphocyte dysfunction,subsequently resulting in infection,which not only delays the recovery time,but also causes deaths in severe cases.Positive nutrition support therapy after lymphatic leakage can help patients recover smoothly.In this paper,the causes,clinical manifestations,diagnosis and treatment of lymphatic leakage are mainly discussed and analyzed.