CAJ | 학술논문

目的:探讨颈清术后乳糜瘘的预防及治疗措施.方法:回顾性分析泰安市肿瘤防治院外科1994年9月～2008年3月493例颈清术后11例乳糜瘘的临床资料,评价乳糜瘘的治疗效果.结果:11例乳糜瘘中左侧9例,右侧2例;直接再手术3例(手术缝扎1例,手术缝扎并肌瓣填塞2例),均一期愈合;8例采用负压吸引、局部加压及低脂饮食的保守治疗,其中7例获得痊愈,平均愈合时间为10天(4～21天),1例失败,经手术治疗(肌瓣填塞)而痊愈.结论:熟悉颈部胸导管解剖、提高手术技巧是减少颈清术后乳糜瘘发生的关键;乳糜瘘经积极而合理的保守治疗或手术治疗是可以治愈的.
목적:탐토경청술후유미루적예방급치료조시.방법:회고성분석태안시종류방치원외과1994년9월～2008년3월493례경청술후11례유미루적림상자료,평개유미루적치료효과.결과:11례유미루중좌측9례,우측2례;직접재수술3례(수술봉찰1례,수술봉찰병기판전새2례),균일기유합;8례채용부압흡인、국부가압급저지음식적보수치료,기중7례획득전유,평균유합시간위10천(4～21천),1례실패,경수술치료(기판전새)이전유.결론:숙실경부흉도관해부、제고수술기교시감소경청술후유미루발생적관건;유미루경적겁이합리적보수치료혹수술치료시가이치유적.
Objective:To evaluate prevention and management for chylous fistulas undergoing dissection. Methods:The clinical materials of 11 cases chylous fistulas after 493 cases neck dissection were analyzed retrospectively from September 1994 to March 2008. Results:Of 11 chylous fistulas, 9 were left-sided and 2 were right-sided. Surgery 3(surgery seam grips 1 case again directly,surgery seam grips and muscle petal pads 2 cases), homogeneous time cicatrization. Conservative therapy which included closed-wound drainage and local pressure dressing and/or low-fat nutritional support was employed in 8 cases, 7 cases were successfully treated, the average duration time for healing was 10 days(4-21 days), the remaining 1 case failed to had and were further treated surgically. Conclusion:The key of reduce fistulas is familiar anatomy for neck dissection. Chylous fistula can be cured after positive and reasonable conservative and/or surgical treatment.