高渗糖局部注射治疗甲状腺癌颈部淋巴结清扫术后淋巴漏疗效分析

Analysis on the efficacy of hypertonic sugar local injection in the treatment of lymphatic leakage after cervical lymph node dissection for thyroid cancer

目的探讨高渗糖局部注射用于甲状腺癌术后淋巴漏病人的疗效。方法回顾性分析郑州大学第一附属医院甲状腺外一科2017年2月至2018年12月术后出现难治性淋巴漏并行高渗糖注射的9例病人资料。结果 9例病人中,8例应用高渗糖后引流液持续减少并最终拔管,3例首次应用且引流液下降50%以上,4例病人连续注射2 d高渗糖后引流液下降50%以上,1例病人经注射高渗糖无效后,行二次手术结扎,并最终拔管。结论对于甲状腺癌术后合并难治性淋巴漏病人,采用高渗糖局部注射治疗,可促进创面愈合,减少病人痛苦。

Objective To investigate the effect of hypertonic glucose injection on patients with chylous leakage after neck dissection.Methods The clinical data of 9 patients with postoperative chylous fistula after the lymph node dissection of thyroid cancer from February 2017 to December 2018 in the Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University were collected and analyzed.Results As for 9 patients with intractable chylous fistula,8 patients were finally cured and had the drainage tube removed.Three patients decreased significantly by over 50% on next day after hypertonic glucose injection.Four patients decreased significantly by over 50% on next two daysafter hypertonic glucose injection.One patient had to have another one operation to cure chylous fistula.Conclusion In patients with chylous fistula after thyroid cancer surgery,local injection of hypertonic glucose seems to be more effective in shortening time of drainage tube remining,which would promote wound healing and release pains.