目的探討粘貼式負壓沖洗在頸淋巴結清掃術后并發(fā)乳糜瘺治療中的作用。方法回顧性分析我院2004年1月至2010年12月期間20例頸淋巴結清掃術后并發(fā)乳糜瘺患者的臨床資料。結果20例患者中18例經粘貼式負壓沖洗后,在5 d內引流量明顯減少,住院時間10~12 d,平均11.3 d; 在治療過程中未出現(xiàn)感染、水腫、皮膚破潰等并發(fā)癥。另外2例經粘貼式負壓沖洗治療無效,轉為手術治療,分別于術后15 d及17 d痊愈出院。結論粘貼式負壓沖洗是治療頸淋巴結清掃術后乳糜瘺的較為有效、理想的方法,具有創(chuàng)傷小,愈合時間短,費用少,患者較易接受等優(yōu)點。
引用本文: 陳少全,呂云霄,王烈. 粘貼式負壓沖洗治療頸淋巴結清掃術后乳糜瘺20例臨床分析. 中國普外基礎與臨床雜志, 2011, 18(10): 1084-1086. doi: 復制
1. | Rollon A, Salazar C, Mayorga F, et al. Severe cervical chyle fistula after radical neck dissection [J]. Int J Oral Maxillofac Surg, 1996, 25(5): 363365. |
2. | 鄭澤霖, 孫輝, 蓋寶東. 甲狀腺疾病外科治療的熱點和難點 [J]. 中國普外基礎與臨床雜志, 2008, 15(5): 307310. |
3. | López Otero MJ, Fernández López MT, Outeirio Blanco E, et al. Neck chylous fistula: conservative treatment [J]. Nutr Hosp, 2010, 25(6): 10411044. |
4. | Kupferman ME, Patterson DM, Mandel SJ, et al. Safety of modified radical neck dissection for differentiated thyroid carcinoma [J]. Laryngoscope, 2004, 114(3): 403406. |
5. | Raguse JD, Pfitzmann R, Bier J, et al. Lowerextremity lymphedema following neck dissection-an uncommon complication after cervical ligation of the thoracic duct [J]. Oral Oncol, 2007, 43(8): 835837. |
6. | 宋文哲, 郭萌. 甲狀腺癌頸淋巴結清掃術后乳糜漏的防治(附19例報道) [J]. 中國普外基礎與臨床雜志, 2009, 16(5): 360361. |
7. | 魏濤, 張國勇, 張明. 超聲刀頸淋巴結清掃術后乳糜瘺 [J]. 中國普外基礎與臨床雜志, 2011, 18(4): 411413. |
8. | 謝樹奪, 陳文軍, 秦川, 等. 內鏡輔助生物膠黏合治療頸部乳糜瘺二例 [J]. 中華普通外科雜志, 2007, 22(5): 331. |
9. | 王圣應, 王鎮(zhèn)寰, 張榮新. 頸段胸導管的臨床應用解剖研究 [J]. 淮海醫(yī)藥, 2000, 18(4): 241242. |
10. | 沐旭升. 胸導管頸段的應用解剖 [J]. 福建醫(yī)學院學報, 1990, 24(1): 9395. |
11. | Van Pernis PA. Variations of the thoracic duct [J]. Surgery, 1949, 26(5): 806809. |
12. | Smoke A, Delegge MH. Chyle leaks: consensus on management? [J]. Nutr Clin Pract, 2008, 23(5): 529532.. |
13. | 李正江, 唐平章. 頸廓清術后乳糜瘺的治療及預防 [J]. 中華耳鼻咽喉科雜志, 1998, 33(4): 244246. |
14. | Nussenbaum B, Liu JH, Sinard RJ. Systematic management of chyle fistula: the Southwestern experience and review of the literature [J]. Otolaryngol Head Neck Surg, 2000, 122(1): 3138. |
15. | Scorza LB, Goldstein BJ, Mahraj RP. Modern management of chylous leak following head and neck surgery: a discussion of percutaneous lymphangiographyguided cannulation and embolization of the thoracic duct [J]. Otolaryngol Clin North Am, 2008, 41(6): 12311240. |
16. | 陳雪敏, 李加枝. 甲狀腺癌術后并發(fā)頸淋巴漏22例分析 [J]. 浙江臨床醫(yī)學, 2002, 4(1): 22. |
17. | 陳少全, 王振發(fā), 王烈, 等. 封閉式負壓沖洗器治療甲狀腺癌根治術后嚴重乳糜漏1例 [J]. 中國普通外科雜志, 2007, 16(11): 1136. |
- 1. Rollon A, Salazar C, Mayorga F, et al. Severe cervical chyle fistula after radical neck dissection [J]. Int J Oral Maxillofac Surg, 1996, 25(5): 363365.
- 2. 鄭澤霖, 孫輝, 蓋寶東. 甲狀腺疾病外科治療的熱點和難點 [J]. 中國普外基礎與臨床雜志, 2008, 15(5): 307310.
- 3. López Otero MJ, Fernández López MT, Outeirio Blanco E, et al. Neck chylous fistula: conservative treatment [J]. Nutr Hosp, 2010, 25(6): 10411044.
- 4. Kupferman ME, Patterson DM, Mandel SJ, et al. Safety of modified radical neck dissection for differentiated thyroid carcinoma [J]. Laryngoscope, 2004, 114(3): 403406.
- 5. Raguse JD, Pfitzmann R, Bier J, et al. Lowerextremity lymphedema following neck dissection-an uncommon complication after cervical ligation of the thoracic duct [J]. Oral Oncol, 2007, 43(8): 835837.
- 6. 宋文哲, 郭萌. 甲狀腺癌頸淋巴結清掃術后乳糜漏的防治(附19例報道) [J]. 中國普外基礎與臨床雜志, 2009, 16(5): 360361.
- 7. 魏濤, 張國勇, 張明. 超聲刀頸淋巴結清掃術后乳糜瘺 [J]. 中國普外基礎與臨床雜志, 2011, 18(4): 411413.
- 8. 謝樹奪, 陳文軍, 秦川, 等. 內鏡輔助生物膠黏合治療頸部乳糜瘺二例 [J]. 中華普通外科雜志, 2007, 22(5): 331.
- 9. 王圣應, 王鎮(zhèn)寰, 張榮新. 頸段胸導管的臨床應用解剖研究 [J]. 淮海醫(yī)藥, 2000, 18(4): 241242.
- 10. 沐旭升. 胸導管頸段的應用解剖 [J]. 福建醫(yī)學院學報, 1990, 24(1): 9395.
- 11. Van Pernis PA. Variations of the thoracic duct [J]. Surgery, 1949, 26(5): 806809.
- 12. Smoke A, Delegge MH. Chyle leaks: consensus on management? [J]. Nutr Clin Pract, 2008, 23(5): 529532..
- 13. 李正江, 唐平章. 頸廓清術后乳糜瘺的治療及預防 [J]. 中華耳鼻咽喉科雜志, 1998, 33(4): 244246.
- 14. Nussenbaum B, Liu JH, Sinard RJ. Systematic management of chyle fistula: the Southwestern experience and review of the literature [J]. Otolaryngol Head Neck Surg, 2000, 122(1): 3138.
- 15. Scorza LB, Goldstein BJ, Mahraj RP. Modern management of chylous leak following head and neck surgery: a discussion of percutaneous lymphangiographyguided cannulation and embolization of the thoracic duct [J]. Otolaryngol Clin North Am, 2008, 41(6): 12311240.
- 16. 陳雪敏, 李加枝. 甲狀腺癌術后并發(fā)頸淋巴漏22例分析 [J]. 浙江臨床醫(yī)學, 2002, 4(1): 22.
- 17. 陳少全, 王振發(fā), 王烈, 等. 封閉式負壓沖洗器治療甲狀腺癌根治術后嚴重乳糜漏1例 [J]. 中國普通外科雜志, 2007, 16(11): 1136.