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乳糜胸是食管癌术后严重并发症之一,如处理不当,可危及生命。本组手术治疗食管癌473例(不包括贲门癌),发生乳糜胸2例(0.42％),均经胸腔引流加胸腔内注射四环素液而治愈,现报告如下。例1 女性,46岁,因食管中段癌进左胸手术弓上吻合。术后第2天拔除引流管,发现有少量淡黄色液体流出,引流管腔有纤维素条索堵塞。术后第3天,患者自觉心慌气急,两肺有哮鸣音,左肺呼吸音低,经吸氧和氨茶硷等治疗未见明显好转,当晚气急加重,并从原引流口自行溢出淡黄色液体约2,000ml,症状明显改善。术后第4天作X线胸透,左胸中等量积液,重新安置闭式引流管,引出淡黄色胸液约1,500ml,胸液乳糜试验阳性。口服美蓝无蓝色胸液,诊断乳糜胸。除积极补液,输血和纠正水电解质平衡外,分别于术后第7、9和11天,每天一次胸腔内注射0.5g四环素液,乳糜液逐日减少,术后第11天拔管。经X线检查,胸腔无积
Chylothorax is one of the serious postoperative complications of esophageal cancer. Improper handling can endanger life. This group of surgical treatment of 473 cases of esophageal cancer (excluding cardiac cancer), occurred in 2 cases of chylothorax (0.42%), were chest cavity drainage plus intrapleural injection of tetracycline solution to cure, the report is as follows. Case 1 Female, 46 years old, had an anastomosis of the middle esophageal cancer into the left thoracic surgery. The drainage tube was removed on the second postoperative day and a small amount of pale yellow liquid was observed. The drainage lumen was blocked by cellulose strips. On the 3rd day after the operation, the patient felt flustered and irritated. The two lungs had wheezy sounds. The left lung had low breath sounds. There was no obvious improvement in the treatment of oxygen absorption and ammoniacal saponins. The air was aggravated later and overflowed from the original drainage port. About 2,000 ml of yellow liquid, the symptoms improved significantly. X-ray chest x-ray was performed on the fourth postoperative day. The left thoracic cavity was moderately effusion. The closed drainage tube was re-arranged and approximately 1,500 ml of light yellow thoracic fluid was elicited. The pleural fluid chyle test was positive. Oral methylene blue without blue broth, diagnosis of chylothorax. In addition to active rehydration, blood transfusion and correction of water-electrolyte balance, 0.5 g tetracycline solution was intrapleurally injected once daily on the 7th, 9th, and 11th day after surgery. The amount of chylous fluid decreased day by day and the tube was extubated on the 11th day after surgery. After X-ray examination, no chest product