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| 经淋巴结淋巴造影术联合α-1肾上腺素受体激动剂米多君治疗术后乳糜胸的初步分析 |
| A Preliminary Analysis of Intranodal Lymphangiography Combined with Midodrine, an α-1 Adrenergic Receptor Agonist, as a Treatment Strategy for Postoperative Chylothorax |
| 投稿时间：2025-01-07 修订日期：2025-01-07 |
| DOI： |
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| 中文关键词: 胸部恶性肿瘤 术后乳糜胸 经淋巴结淋巴造影术 米多君 |
| 英文关键词:【Keywords】 Thoracic malignancy Postoperative chylothorax Lymph node iodized oil lymphangiography Midodrine |
| 基金项目:中国癌症基金会北京希望马拉松专项基金(LC2020A02) |
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| 中文摘要: |
| 【摘要】
目的：初步评估经淋巴结淋巴造影术联合米多君治疗胸部恶性肿瘤术后乳糜胸的安全性、初步临床疗效及技术可行性。方法：回顾性分析2022年10月至2023年9月于中国医学科学院肿瘤医院收治的5例经保守治疗无效的难治性术后乳糜胸患者的临床资料。所有患者均在超声及X线引导下行经淋巴结淋巴造影术，并于围手术期应用米多君治疗。结果：所有5例患者均成功行经淋巴结淋巴造影术，并成功定位乳糜漏，技术成功率为100%。平均手术时长为（2.8 ± 1.3）小时。患者平均胸腔引流量由术前的（425.9 ± 178.9）毫升显著下降至术后的（40.7 ± 10.1）毫升。术后平均拔管时间为（5 ± 4.5）天，治疗期间未发生严重并发症。结论：经淋巴结淋巴造影术联合α-1肾上腺素受体激动剂米多君，对于保守治疗无效的术后乳糜胸可能是一种潜在的治疗选择。
【关键词】胸部恶性肿瘤；术后乳糜胸；经淋巴结淋巴造影术；米多君 |
| 英文摘要: |
| Objective: To evaluate the safety, preliminary clinical efficacy, and technical feasibility of intranodal lymphangiography combined with midodrine for postoperative chylothorax following thoracic malignancy surgery. Methods: A retrospective analysis was conducted on the clinical data of 5 patients with refractory postoperative chylothorax who failed conservative treatment at Cancer Hospital, Chinese Academy of Medical Sciences from October 2022 to September 2023. All patients underwent ultrasound and X-ray-guided intranodal lymphangiography with perioperative administration of midodrine. Results: Intranodal lymphangiography was successfully performed in all 5 patients, with chyle leak identified, achieving a technical success rate of 100%. The mean operative time was (2.8 ± 1.3) hours. The mean chest tube drainage volume significantly decreased from (425.9 ± 178.9) ml preoperatively to (40.7 ± 10.1) ml postoperatively. The mean time to chest tube removal was (5 ± 4.5) days. No serious complications occurred during treatment. Conclusion: Intranodal lymphangiography combined with midodrine, an α-1 adrenergic receptor agonist, may represent a potential therapeutic option for postoperative chylothorax refractory to conservative treatment. |
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