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目的 通过对1317例次颈清扫术中11例乳糜或淋巴瘘处理临床经验总结,探讨更为有效的处理乳糜或淋巴瘘的方法。方法 11例乳糜或淋巴瘘采用持续负压吸引,负压吸引在—2.2kpa至—6.8kpa之间,局部适当加压包扎方法处理。结果 其中左颈清扫中5例,发生率为0.8％(5/626),右颈清扫中6例,发生率为0.9％(6/691)。日引流量50毫升至400毫升。多数术后10天内瘘口闭合,2例术后3周内完全闭合。无需手术探查,无1例死亡。结论 熟悉淋巴管解剖和仔细操作是减少乳糜或淋巴瘘发生的关键,持续负压吸引适当加压包扎是一种较为安全有效的方法。
Objective To summarize the clinical experience of treating 11 cases of chyloplasty or lymphatic fistula in 1317 cases of neck dissection, and to explore a more effective method to treat chyloplast or lymphatic fistula. Methods Eleven cases of chronic hernia or lymphatic hernia were treated with continuous vacuum suction. The suction pressure was between -2.2kpa and -6.8kpa. Results There were 5 cases of left neck dissection, the incidence was 0.8% (5/626), and 6 cases were right neck dissection. The incidence was 0.9% (6/691). Drain the flow from 50 ml to 400 ml. Most fistulas closed within 10 days after operation, and 2 cases completely closed within 3 weeks after operation. No need for surgical exploration, no 1 death. Conclusion To be familiar with lymphatic dissection and careful operation is the key to reduce the occurrence of chyloplasty or lymphatic fistula. Sustained negative pressure and appropriate pressure dressing is a safe and effective method.