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甲状腺癌是颈部最常见的恶性肿瘤,相当大部分患者需要行颈淋巴结清扫手术。由于颈部具有丰富的淋巴回流,尤其是淋巴导管及乳糜管均在颈部汇入静脉系统,颈淋巴结清扫术后颈淋巴,管或乳糜管若损伤,会并发乳糜漏。乳糜漏是颈廓清术后一种对生命有潜在威胁的并发症。文献报道,颈廓清术后或颈部外伤后乳糜漏的发生率为1%～3%,如得不到合理处置,可导致病人血容量减少,电解质紊乱。淋巴细胞下降及低蛋白血症,严重者导致病人死亡。我科2002年12月～2005年8月用肩胛舌骨肌填塞预防及治疗甲状腺癌颈淋巴结清扫术中术后出现乳糜漏8例(其中术中2例,术后6例),操作简单,疗效好,现将临床资料报告如下。
Thyroid cancer is the most common malignancy in the neck. A significant proportion of patients require cervical lymph node dissection. As the neck is rich in lymph reflux, especially the lymphatic duct and chylothorax in the neck into the venous system, cervical lymph node dissection neck lymph duct, or duct if the lesion, chylothorax will be complicated. Chylothorax is a potential complication of life after neck dissection. Reported in the literature, after neck dissection or neck trauma, the incidence of chylous leakage was 1% to 3%, if not properly treated, can lead to reduced blood volume, electrolyte imbalance. Lymphopenia and hypoproteinemia, severe cases lead to the death of patients. Our department from December 2002 to August 2005 with scapular hyoid muscle padding in the prevention and treatment of thyroid cancer neck lymph node dissection in 8 cases (including 2 cases after surgery, 6 cases after surgery), simple operation, Good effect, now the clinical data reported as follows.