摘要
目的:探讨甲状腺癌中央区淋巴结清除术后乳糜漏发生的原因及有效的防治措施。方法:选取天津医科大学肿瘤医院2013年7月至2015年6月6 127例甲状腺癌中央区淋巴结清除术病例,其中14例患者术后并发乳糜漏。采取全身治疗、局部加压包扎、常压引流、50%葡萄糖注射液或平阳霉素经引流管注入等保守治疗,保守治疗效果不理想时行手术治疗。结果:12例患者行保守治疗后,引流量逐渐减少,至<10 m L/d时拔除引流管;2例患者保守治疗后,引流量未见明显减少,行手术治疗。结论:甲状腺癌中央区淋巴结清除术时应仔细操作以预防乳糜漏的发生,发生后行保守治疗,保守治疗无效时行手术治疗。
Objective：To discuss the causes and effective measures of prevention and treatment of chylous fistula after central lymph node dissection （CLND） of thyroid cancer.Methods：A total of 6 127 patients who underwent CLND of thyroid cancer in the Tianjin Medical University Cancer Institute and Hospital between July2013and June 2015were analyzed; of which,14patients acquired the complication of postoperative chylous fistula. The following conservative treatments were initially performed： systemic therapy, local pressure bandaging, normal pressure drainage,50% glucose injection, or pingyangmycin injection through a drainage tube. Surgical op-eration was then conducted when the efficacy of the treatment was poor. Results：After the conservative treatment of the14patients, the drainage volume gradually decreased in12patients, and surgery was performed on the remaining two patients. Conclusion： The CLND of thyroid cancer must be carefully conducted to prevent postoperative chylous fistula. An active conservative treatment must be the first option when chylous fistula occurs. Surgery must only be performed if the treatment is invalid.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2016年第2期72-75,共4页
Chinese Journal of Clinical Oncology
关键词
甲状腺癌
中央区淋巴结清除术
并发症
乳糜漏
防治
thyroid cancer, central lymph node dissection, complication, chylous fistula, prevention and treatment
