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目的探讨肝硬化所致乳糜性胸水的临床特点及诊断方法。方法回顾分析我院2003年1月至2009年12月诊断4例肝硬化所致乳糜胸水的临床病例资料,分析其临床特点、诊断和治疗效果。结果 4例患者均携带有乙型肝炎病毒。胸水检查:外观为黄白色或白色乳糜状,实验室检查确诊为真性乳糜胸水(乳糜试验及苏丹Ⅲ染色均阳性)。在综合治疗的基础上,结合胸腔粘连术或经颈静脉肝内门体分流术(TIPS)对肝硬化所致乳糜性胸水的近期治疗效果良好。结论肝硬化并乳糜胸水在临床上比较少见。治疗上可在常规护肝、支持治疗的同时,根据患者病情选择TIPS、胸腔粘连术或胸导管结扎术等有一定疗效。
Objective To investigate the clinical features and diagnosis of chylothorax caused by cirrhosis. Methods A retrospective analysis of our hospital from January 2003 to December 2009 diagnosis of cirrhosis in 4 cases of chylothorax clinical data, analysis of its clinical features, diagnosis and treatment. Results All 4 patients had hepatitis B virus. Pleural fluid examination: the appearance of yellowish white or white chyle, laboratory tests confirmed true chylothorax (chylous test and Sudan Ⅲ staining were positive). On the basis of comprehensive treatment, combined with thoracic adhesions or transjugular intrahepatic portosystemic shunt (TIPS) of cirrhosis of the chylous pleural effusion treated with good results recently. Conclusions Cirrhosis and chylothorax are relatively rare in clinic. Treatment can be routine liver protection, supportive treatment at the same time, according to the patient’s condition to choose TIPS, thoracic adhesions or thoracic duct ligation have a certain effect.