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目的比较颈清扫术后乳糜瘘治疗方法的临床效果。方法回顾分析1993年7月2009年8月,就诊的21例根治性颈清扫术后乳糜瘘的治疗方法及其临床效果。结果加压包扎法5例,加压包扎辅以胃肠外营养6例,手术探查结扎2例,结扎后辅以生物胶覆盖结扎创面2例,行负压吸引加胃肠外营养6例,均治愈。5例单纯加压包扎法用时4～8d,其中1例辅以拆线引流碘仿纱条填塞加压后愈合,4例手术止瘘者均Ⅰ期愈合。其余外加压2d无效,行外加压辅以胃肠外营养或负压吸引辅以胃肠外营养后愈合。结论多种乳糜瘘的治疗方法均有明显临床效果,应该根据患者的具体情况采用。其中胃肠外营养在治疗中占有重要的地位。
Objective To compare the clinical effects of the treatment of chylous fistula after neck dissection. Methods Retrospective analysis of July 1993 August 2009, treatment of 21 cases of radical neck dissection after the treatment of chylous fistula and its clinical effect. Results 5 cases of compression bandage method, pressure banding combined with parenteral nutrition in 6 cases, surgical exploration ligation in 2 cases, ligation supplemented with bio-plastic cover ligation wound in 2 cases, negative pressure plus parenteral nutrition in 6 cases, All cured. 5 cases of simple compression bandage method with 4 ~ 8d, of which 1 case supplemented by stitching drainage iodoform gauze healed after packing, 4 cases of surgical fistula were healed. The rest of the external pressure 2d invalid, external pressure supplemented by parenteral nutrition or negative pressure supplemented by parenteral nutrition after healing. Conclusion A variety of chylous fistula treatment methods have obvious clinical effects, should be based on the specific circumstances of patients. Among them, parenteral nutrition plays an important role in the treatment.