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目的:探讨食管癌术后发生乳糜胸的诊断和治疗方法。方法:回顾性分析20例食管癌患者术后发生乳糜胸的临床资料,20例患者先行保守治疗,治疗5d后胸腔引流量无减少者6例行手术治疗。结果:食管癌术后2~4d出现乳糜胸6例,其中胸腔引流量>1000ml/d者4例,<1000ml/d者2例;术后5~12d出现14例,其中>1000ml/d者6例,<1000ml/d者8例。20例中保守治疗治愈14例,6例经开胸手术结扎胸导管治愈。结论:食管癌患者术后胸腔引流量持续>1000ml/d或拔除胸腔引流管后术侧胸腔再次出现大量胸水,结合胸腔引流液乳糜试验结果,是食管癌术后乳糜胸的主要诊断方法;乳糜胸应先行保守治疗,经保守治疗5d后胸腔引流量无减少者选择手术治疗。
Objective: To investigate the diagnosis and treatment of chylothorax after esophageal cancer surgery. Methods: The clinical data of 20 patients with esophageal cancer who underwent chylothorax were retrospectively analyzed. Twenty patients were treated conservatively. After 5 days of treatment, there was no decrease in chest drainage and 6 patients were treated surgically. Results: There were 6 cases of chylothorax 2 ~ 4 days after operation in esophageal squamous cell carcinoma, including 4 cases of drainage volume> 1000ml / d and 2 cases of <1000ml / d in esophageal cancer. There were 14 cases in 5 ~ 12 days after operation, of which> 1000ml / 6 cases, <1000ml / d in 8 cases. In the 20 cases, 14 cases were cured by conservative treatment and 6 cases were thoracotomy ligation thoracotomy. Conclusions: Pleural effusion in patients with esophageal cancer> 1000ml / d or pleural drainage after removal of the pleural effusion pleural effusion pleural effusion after a large number of pleural effusion, combined with chest drainage fluid chyle test results, is the main diagnosis of postoperative esophageal chylothorax; chyle Chest should be the first conservative treatment, conservative treatment 5d after thoracic drainage without reducing the choice of surgical treatment.