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目的探讨非解剖性胸导管整块结扎切断在复发性乳糜胸手术治疗中的应用。方法胸导管结扎术后复发性乳糜胸患者22例,总结22例患者手术方式、原手术径路、乳糜胸复发部位和再次术后并发症,分析其乳糜胸复发的可能原因并在常规胸导管整块结扎术的基础上进行针对性改进,采用将除食管、降主动脉以外的后纵隔组织非解剖性整块结扎切断的方式进行再次手术治疗。结果 22例复发性乳糜胸患者再次手术后乳糜胸均缓解,除1例患者术后并发呼吸衰竭外,其余患者术后无严重并发症,术后随访1年无乳糜胸复发。结论采用非解剖性胸导管整块结扎切断手术方式通过消除乳糜胸复发的解剖学基础能够安全有效的治疗复发性乳糜胸。
Objective To investigate the application of non-anatomic thoracic duct ligation and ligation in the treatment of recurrent chylothorax. Methods Twenty-two patients with recurrent chylothorax after thoracotomy were enrolled in this study. Twenty-two patients were enrolled in this study. The surgical procedure, surgical approach, recurrence of chylothorax and postoperative complications were analyzed. The possible causes of chylothorax recurrence were analyzed. Block ligation on the basis of targeted improvements, except the esophagus, the descending aorta after the mediastinal non-anatomical ligation cut off the way again surgery. Results All of the 22 patients with recurrent chylothorax were relieved after reoperation. Except one patient with postoperative respiratory failure, the other patients had no serious postoperative complications and were followed up for 1 year without chylothorax recurrence. Conclusion Non-anatomic thoracic duct ligation and ligation can effectively and safely treat recurrent chylothorax by eliminating the anatomic basis of chylothoracic recurrence.