【摘要】：目的:探討甲狀腺癌頸部淋巴結(jié)清掃術(shù)后雙側(cè)乳糜胸的診斷及治療。方法:回顧性分析2例甲狀腺癌頸部淋巴結(jié)清掃術(shù)后出現(xiàn)的雙側(cè)乳糜胸患者的臨床資料,并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果:2例患者均因甲狀腺乳頭狀癌行頸部淋巴結(jié)清掃術(shù),術(shù)中均未發(fā)現(xiàn)淋巴液滲漏。均于術(shù)后第4天出現(xiàn)氣促、呼吸困難,經(jīng)胸部X線檢查為雙側(cè)胸腔積液,行雙側(cè)胸腔閉式引流出乳白色乳糜液,證實(shí)為雙側(cè)乳糜胸。2例患者經(jīng)禁食、奧曲肽等積極治療后,引流量逐漸減少,復(fù)查胸部X線胸部無(wú)積液后拔除引流管。結(jié)論:雙側(cè)乳糜胸是甲狀腺癌頸淋巴結(jié)清掃術(shù)后罕見(jiàn)的并發(fā)癥,早期發(fā)現(xiàn)后給予積極的保守治療是安全有效的。
[Abstract]:Objective: to investigate the diagnosis and treatment of bilateral chylothorax after neck lymph node dissection for thyroid carcinoma. Methods: the clinical data of 2 patients with bilateral chylothorax after neck lymph node dissection for thyroid carcinoma were analyzed retrospectively. Results: cervical lymph node dissection was performed in 2 patients with papillary thyroid carcinoma. No lymphatic leakage was found during the operation. On the 4th day after operation, the patients developed shortness of breath and dyspnea. Chest X-ray examination showed bilateral pleural effusion and closed drainage of white chylothorax, which was confirmed as bilateral chylothorax. 2 patients were treated with fasting and octreotide. The drainage volume gradually decreased, and the drainage tube was removed after reexamination of chest X-ray without hydrothorax. Conclusion: bilateral chylothorax is a rare complication after neck lymph node dissection in thyroid carcinoma.
【作者單位】： 中南大學(xué)湘雅醫(yī)院普通外科甲狀腺專科;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(81372860)
【分類號(hào)】：R736.1

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本文編號(hào)：2341804