妊娠期慢性咳嗽致左侧乳糜胸1例并文献复习

A case report of left chylothorax caused by chronic cough during pregnancy and literature review

目的探讨妊娠期慢性咳嗽致左侧乳糜胸的诊治经验。方法总结西南交通大学附属医院妇产科2021年5月收治的1例妊娠期慢性咳嗽致左侧乳糜胸病人的诊治经过并复习国内外文献,对该病相关的临床特征及诊治进行总结。结果病人妊娠期咳嗽2月,未予治疗,于孕30周,出现气促胸闷,影像学提示左侧胸腔大量积液,胸腔穿刺引流出乳白色浑浊液体。保守治疗及终止妊娠均治疗效果不佳,行手术治疗后胸腔乳糜引流液逐步减少至停止,随访病人恢复良好。结论妊娠期慢性咳嗽可导致乳糜胸,该病诊断依靠病史及相关辅助检查,手术治疗是关键。

Objective To explore the diagnosis and treatment experience of left chylothorax caused by chronic cough during pregnancy.Methods The diagnosis and treatment of a patient with left chylothorax caused by chronic cough during pregnancy admitted to the Department of Obstetrics and Gynecology, Affiliated Hospital of Southwest Jiaotong University in May 2021 were summarized, and the literature at home and abroad was reviewed to summarize the clinical characteristics and diagnosis and treatment of the disease.Results The patient had cough for 2 months during pregnancy and was not treated. At 30 weeks of pregnancy, patient developed shortness of breath and chest tightness. Imaging showed a large amount of effusion in the left thoracic cavity, and milky white turbid liquid was drained by thoracic puncture. Conservative treatment and termination of pregnancy were ineffective. After surgical treatment, the thoracic chyle drainage was gradually reduced to stop, and the follow-up patients recovered well.Conclusions Chronic cough during pregnancy can lead to chylothorax. The diagnosis of the disease depends on medical history and related auxiliary examinations. Surgical treatment is the key.