CAJ | 학술논문

目的评估颈部手术后乳糜漏并发症的综合保守治疗的效果.方法回顾性分析1992年6月至2008年6月共收治的39例颈部手术后乳糜漏患者.分别采用饮食控制(调整饮食为高热量、高蛋白、低脂肪饮食,食物中仅含中链甘油三酯);静脉营养支持;补充水、电解质等对症治疗;局部加压包扎;持续强负压(-50～-80 kPa)吸引引流乳糜;生长抑索类似物的应用等综合保守治疗,通过观察术后患者乳糜引流量的变化评估疗效.结果乳糜漏均发牛在颈部手术后2～5 d,39例患者中高流量(≥500 ml/d)7例,每日乳糜引流量最高达1440 ml,均通过综合保守治疗痊愈,愈合时间3～12 d,平均(6.2±2.3)d(x±s).无再手术患者,未发生切口积液、感染等并发症.随访4个月～11年无复发病例.结论综合保守治疗是处理颈部手术后乳糜漏并发症安全有效的方法.
목적 평고경부수술후유미루병발증적종합보수치료적효과.방법 회고성분석1992년6월지2008년6월공수치적39례경부수술후유미루환자.분별채용음식공제(조정음식위고열량、고단백、저지방음식,식물중부함중련감유삼지);정맥영양지지;보충수、전해질등대증치료;국부가압포찰;지속강부압(-50～-80 kPa)흡인인류유미;생장억색유사물적응용등종합보수치료,통과관찰술후환자유미인류량적변화평고료효.결과 유미루균발우재경부수술후2～5 d,39례환자중고류량(≥500 ml/d)7례,매일유미인류량최고체1440 ml,균통과종합보수치료전유,유합시간3～12 d,평균(6.2±2.3)d(x±s).무재수술환자,미발생절구적액、감염등병발증.수방4개월～11년무복발병례.결론 종합보수치료시처리경부수술후유미루병발증안전유효적방법.
Objective To explore and evaluate the combined conservative managements in the treatment of cervical chylous leakage. Methods Thirty nine eases of cervical chylous leakage from Jun 1992 to Jun 2008 were retrospectively analyzed in this hospital. All of the 39 eases were cured by treating with conservative individualized therapy, including the applying of diet with high calory, high protein and low fat and fatty food should only contains medium-chain triglycerides, total parenteral nutrition, keep the balance of hydrogen and electrolyte and correct hypoproteinemia, local pressure dressing, high persistent vacuum drainage (- 50～ - 80 kPa) and/or somatostatin analogue. Results All the cases of chylous leakage happened 2nd to 5th days after the operation. Among the 39 cases, 7 were high flow (drainage ≥500 ml/d) chylous leakage, the amount of drainage reached as high as 1440 ml per day. The time of chylous leakage closure was 3～12 days, and the mean time was 7 days. No one experienced re-operation, wound hydrops or wound infection. Condusions The conservative individualized therapy may play a key role in the treatment of cervical chylous leakage.